Note: The job is a remote job and is open to candidates in USA. CareSource is a healthcare company, and they are seeking an Actuarial Analyst II (Medicare) to provide timely and accurate data analysis. The role involves developing recommendations, conducting profitability reports, and participating in cross-functional teams to improve operational efficiency.
Responsibilities
- Develops actionable recommendations to management relative to all analysis
- Calculates profitability reports on appropriate business segments
- Leads regular and ad-hoc analysis identifying opportunities to improve efficiency and affordability
- Leads regular and ad-hoc analysis/studies to evaluate assumptions used in other processes
- Participates in cross functional teams to address key issues facing the organization
- Prepares monthly calculation of the company's IBNR reserves
- Evaluates government reimbursement process to determine areas of risk and opportunity
- Participates in initiatives to improve operating results
- Initiates key analysis to improve overall MLR results
- Performs other duties as assigned
Skills
- Bachelor's degree in actuarial science, mathematics, economics or a related field is required
- Intermediate database (SAS or Access) experience is required
- A combination of years of industry experience and exams passed under the Society of Actuaries Exam Syllabus (excluding exam SRM via transition credit) equaling 5 or more is required
- Active pursuit of an actuarial designation (ASA) is required
- Intermediate interpersonal/verbal communication skills and a high level of professionalism
- Intermediate written communication skills
- Intermediate ability to work independently and within a team environment
- Intermediate ability to work in fast paced environment with changing priorities
- Intermediate ability to remain calm under pressure
- Intermediate proficiency level with Microsoft Excel
- Intermediate proficiency with Microsoft Suite to include, Word, Power Point and Outlook
- Intermediate ability to effectively present information and respond to questions from peers and management
- Intermediate ability to analyze and interpret financial data in order to coordinate the preparation of financial records
- Intermediate knowledge of SQL, SAS, R, or other data manipulation software
- Effective problem-solving skills with attention to detail
- Effective listening and critical thinking skills
- Experience with Medicare Advantage bids
- Experience with data compilation to support bids
- Experience with desk review audit responses
- Experience developing and using pricing models related to Medicare Advantage
- Experience with Medicare Risk Adjustment
- Experience with building large Excel models
- Proficient with relational databases and coding languages (SQL)
- Experience with DSNP and/or FIDE/HIDE-SNPs
- Minimum of one (1) year of decision support or financial analysis experience is preferred
- Managed Care or healthcare experience is preferred
Benefits
- You may qualify for a bonus tied to company and individual performance
- A substantial and comprehensive total rewards package
Company Overview
CareSource provides managed care services to Medicaid beneficiaries. It was founded in 1989, and is headquartered in Dayton, Ohio, USA, with a workforce of 1001-5000 employees. Its website is https://www.caresource.com/.Company H1B Sponsorship
CareSource has a track record of offering H1B sponsorships, with 30 in 2025, 39 in 2024, 35 in 2023, 21 in 2022, 37 in 2021, 28 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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