Note: The job is a remote job and is open to candidates in USA. WellSense Health Plan is a growing regional health insurance company with a 25-year history of providing health insurance services. The Actuarial Analyst I/II plays a crucial role in the Finance / Actuarial Services team, providing technical support for various actuarial functions including rating/pricing, reserving, and healthcare data analytics.
Responsibilities
• Analyzes financial, statistical and mathematical data and performs actuarial calculations
• Develops premium rates through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost
• Prepares regulatory rate filings, and data or response for additional inquiries
• Develops monthly IBNR reserve estimates for different line of business
• Prepares monthly accruals and contract settlements for different line of business
• Assists in financial budget, reforecast and other financial projections
• Assists in risk adjustment analyses and risk score simulations
• Supports trend development, trend drivers' study, and/or provider contract analytics
• Maintains established reports for internal needs and/or regulatory requirements
• Participates in internal and external audits
• Provides analytic support for corporate initiatives/projects
• Executes SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity
• Summarizes findings and recommendations, and documents the process
• Shares knowledge and provides training to new employees
• Is a participant in good standing in the Actuarial Student Program, and is committed to completing the Society of Actuaries education courses to attain the ASA or FSA designation
Skills
• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Economics or related fields
• At least 2 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis
• Should be experienced in MS Office products, SQL, and SAS or other statistical software
• Should be experienced or proficient in Excel
• Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems
• Ability to work collaboratively with team members and other departments
• Good communications skills
• Is a participant in good standing in the Actuarial Student Program, and is committed to completing the Society of Actuaries education courses to attain the ASA or FSA designation
• Successful completion of at least 3 or more SOA actuarial exams
• A background in managed healthcare, insurance operations
Benefits
• Full-time remote work
• Competitive salaries
• Excellent benefits
Company Overview
• A nonprofit health plan serving Medicare, Individual & Family, and Medicaid plan members in Massachusetts & New Hampshire. It was founded in 1997, and is headquartered in Boston, Massachusetts, US, with a workforce of 1001-5000 employees. Its website is https://wellsense.org.
Company H1B Sponsorship
• WellSense Health Plan has a track record of offering H1B sponsorships, with 1 in 2025, 8 in 2024, 2 in 2023, 2 in 2021, 1 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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