Actuarial Business Consultant - Medicare Risk Adjustment
Elevance Health

Job Info

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Actuarial Business Consultant

Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Preferred Location: Norfolk, VA.

The Actuarial Business Consultant will complete the most diverse and complicated projects and performs highly complex actuarial studies.

How you will make an impact:

• Insources Medicare Advantage Risk Adjustment Analytics from vendors.
• Performs key actuarial functions including new product pricing, evaluation of the impact of new legislation, flexible benefit consulting, and special projects.
• Designs and completes special projects such as developing and maintaining experience-rating formulae and creating and/or reviewing alternative settlement formulate and risk sharing models.
• Responsible for recommendations on pricing, marketing, product design, claims, premium and enrollment administration of business unit.
• Responsible for valuation support for business unit by interpreting financial results, variances from forecast to help identify product and segment behavior to assist in the risk management of the business unit.

Minimum requirements:

Requires a BA/BS in Mathematics, Statistics or related field and minimum of 8 years related experience in an actuarial environment performing financial reporting, rate development, evaluation of risk contingencies and/or trend projections; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, capabilities, and experiences:

Medicare Advantage and/or Medicaid Risk Adjustment experience is strongly preferred.

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