CareSource
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
Medicaid • MyCare Ohio • Health Insurance Marketplace • Medicare Advantage • Health Insurance
Actuarial Analyst II - Medicare
February 18
CareSource
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
Medicaid • MyCare Ohio • Health Insurance Marketplace • Medicare Advantage • Health Insurance
📋 Description
• Responsible for providing timely, accurate, and actionable data, analysis and recommendations supporting the department and corporate key initiatives • Develops actionable recommendations to management • Calculates profitability reports on appropriate business segments • Leads regular and ad-hoc analysis • 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
🎯 Requirements
• Bachelor's degree in actuarial science, mathematics, economics or a related field is required • Minimum of one (1) year of decision support or financial analysis experience is preferred • Intermediate database (SAS or Access) experience is required • Managed Care or healthcare experience is preferred • 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)
🏖️ Benefits
• Comprehensive total rewards package • Employee well-being support • Inclusive environment • Equal Opportunity Employer
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