USACares Jobs

Job Information

Fresenius Medical Care North America Sr. Actuarial Analyst in Austin, Texas

Job ID 200005UC

Available Openings 1

PURPOSE AND SCOPE:

Responsible for analyzing and monitoring related data across the enterprise, applying business knowledge and expertise to support business initiatives and solve business problems, and communicating results and findings to key stakeholders. Responsible for the development, coordination and management of medical economics, models, health services outcome studies and is responsible for the design and development of integrated data analysis products and Pharmacoeconomics data analysis.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Performs assigned actuarial analyses tasks in support of pricing, reserving, provider contract development, and product development. This includes utilizing actuarial systems and programming skills to access and organize the data, performing the applicable actuarial calculations, analyzing moderate to complex information, assessing the reasonability of results and drawing conclusions, updating exhibits and slides, and completing documentation.

  • Assist in the development of pricing methodologies, analysis of the plan’s risk pool and identification of trends in FMC’s cost structure.

  • Support management in the financial feasibility of potential acquisitions, joint ventures, and startup businesses by providing complex analyses and financial models for diverse financial data.

  • Prepare presentations for review by management, board of directors, and diverse governing bodies by providing diverse financial data.

  • Development of revenue and medical claims expense models for evaluating and projecting risk-based contracts with health plan clients, ACOs and government partners.

  • Drive decision making around proposed contract changes and financial evaluation of specific contract terms.

  • Acts as a subject matter expert in medical economics in relation to Medicare and Managed Care.

  • Ensures data integrity is maintained throughout the reporting lifecycle.

  • Collaborate with Finance and other internal departments, including clinical, to analyze financial value of vendor contracts.

  • Drives efforts to continually improve data capabilities and quality of department analysis and reporting.

  • Compile and analyze cost and utilization information to analyze complex system, corporate, or industry performance indicators.

  • Assist with preparing files and materials for internal and external regulatory audits.

  • Identifies discrepancies, risk and root cause for remediation.

  • Perform ad hoc pricing sensitivity analysis and evaluation for Contract Management and other internal customers.

  • Performs other duties as assigned.

PHYSICAL DEMANDS AND WORKING CONDITIONS :

  • The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Little to no travel is expected for this position.

SUPERVISION:

  • None

EDUCATION :

  • Bachelor’s Degree; Advanced Degree desirable or an equivalent combination of education and experience

EXPERIENCE AND REQUIRED SKILLS :

  • 5-10 years related experience.

  • Prior experience in multi-location environment within the healthcare industry preferred.

  • Strong computer skills with demonstrated proficiency in word processing, spreadsheet, presentation, database and email applications.

  • Strong interpersonal skills with the ability to lead effective and productive teams.

  • Excellent oral and written communication skills to effectively communicate with all levels of management.

  • Pursuing ASA designation

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.

DirectEmployers