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Dover, DE 19904
Req ID: 61818BR
- Primary responsibility is support of Small Group and Conversion business in New York – includes pricing, filing, implementation/testing for ACA plans and market-specific support for PEOs and other small-group initiatives in New York.
- May assist with small group / PEO (Professional Employer Organizations) support for New England, New Jersey, Great Lakes, Arizona and Minnesota.
- Partner with Product to optimize benefit plan portfolios by assessing plan performance, developing compliant benefit relativities and AVs, and consulting on the impact of benefit/cost sharing changes.
- Partner with Finance and other market partners to develop Plan/Forecast projections, analyze monthly results, and understand impacts of risk adjustment and membership changes.
- Develop rate filings and understand/support associated regulatory requirements.
- Understand competitive positioning/intelligence and use to influence product and pricing strategies.
- Assist with reserve analysis, including setting and tracking large claim accruals.
- Support ad hoc benefit/cost sharing pricing requests.
Fundamental Components included but are not limited to:
- Manage personal resources efficiently to complete projects, Exhibit innovative use of resources.
- Provide input into decision making process.
- May mentor intern or new employee. Facilitate training and development opportunities.
Product & Business Knowledge:
- Demonstrate understanding of assumptions and the process used to develop them. Incorporate understanding of data sources in the recommendation and implementation of appropriate business decisions.
- Demonstrate understanding of intradepartmental products, programs, processes and policies; research problems and issues.
- Demonstrate understanding of regulatory compliance issues.
Risk Analysis & Management:
- Work with supervisor to understand the nature of specific risks. Analyze data and present preliminary conclusions to supervisors.
- Compile and analyze filing data. Prepare and submit necessary exhibits for regulatory filings.
- Use of Technology- Develop creative technical solutions to a variety of problems.
- Maintenance & Enhancements- Maintain and develop enhancements to processes, tools and systems. Make suggestions to maximize efficiency.
Communication, Collaboration & Constituents:- Constituent Focus- Participate in multi-functional workgroups.
- Verbal & Written Communication- Respond to routine inquiries and provide support in responding to moderately complex constituent inquiries in an accurate and timely manner. Create and maintain accurate documentation and help develop training materials for tools and processes.
- Interaction with Constituents- Collaborate with internal constituents.
Qualifications Requirements and Preferences:
Bachelor’s degree along with 2+ year(s) work experience
Prior healthcare experience preferred
Candidate desired will have passed actuarial exams
Prior experience in pricing, filing and/or small group is helpful
General Business – Applying Reasoned Judgment, General Business – Communicating for Impact, General Business – Turning Data into Information
Additional Job Information:
-Solid technical/analytical skills and attention to detail.
-Ability to think creatively and use analytics to solve ambiguous problems.
-Customer-focused mindset and willingness to address concerns of key market partners.
-Ability to understand complex concepts and communicate effectively to both technical and less-technical audiences.
-Comfortable working in a fast-paced environment and can effectively manage multiple priorities.
-Able to work effectively in a team setting and independently.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Actuarial
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.