AmeriHealth Caritas Actuarial Analyst in Philadelphia, Pennsylvania
Location: Philadelphia, PA
Primary Job Function: Finance
Your career starts now. We’re looking for the next generation of health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .
Support trend analytics and cost containment initiatives as part of a dynamic team. The team identifies drivers of plan performance, investigates improvement initiatives, and evaluates improvement programs. This role will build, share, and maintain dashboards and analyses used to identify meaningful medical trends, and collaborate with subject matter experts to identify root causes of trends. They may also suggest and later test plan improvement initiatives. Will likely work with multiple business segments and departments. The ideal candidate will have a thirst for continuous learning, investigative analytics, customized reporting and creative problem solving. They will be sought out as an expert on the projects they support, sharing work with a wide array of audiences. This is a great opportunity to utilize and extend strong skills in programming, analytics and critical thinking.
Conduct analyses of medical and pharmacy claims to evaluate healthcare cost and utilization.
Manipulate healthcare data from multiple sources to create data sets for analytics and reporting to address business and research questions.
Build and maintain dashboards measuring plan performance.
Perform periodic updates of large data files in claims, membership, providers, etc. and assure the data integrity.
Execute statistical analyses and interpret results in the context of business needs.
Understand healthcare business operations and convert data into usable information.
Education and Experience:
Bachelor’s Degree required in Statistics, Mathematics, Computer Science, or related field.
Having passed Actuarial exams is a plus.
1-3 years’ experience working within a managed care organization, health insurer, or as a consultant.
1-3 years claims analysis or cost reporting experience.
1-3 years working in/from a data warehouse environment.
1-3 years SAS/SQL programming experience.
Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions.
Experience mining large data sets
Proficient with Microsoft Excel and Microsoft PowerPoint.
Established ability to manage multiple tasks.
Excellent written and verbal communication skills.
Strong data presentation skills.
Familiarity with relational database fundamentals.
Familiarity with database applications such as Oracle, Hadoop
Experience developing Tableau Dashboards
Familiarity with Big Data mining tools
EOE Minorities/Females/Protected Veterans/Disabled