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Member Service Representative-Bilingual (Spanish/English) - Rapids Drive Branch

BMC HealthNet Plan

Member Service Representative-Bilingual (Spanish/English) - Rapids Drive Branch

Charlestown, MA +1 location
Full Time
Paid
  • Responsibilities

    The Actuarial Analyst II is a key member of the Finance / Actuarial Services team.  Under direct guidance and supervision, the Actuarial Analyst II applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for rating/pricing, reserving, medical economics, financial forecasting, and/or healthcare data analytics. The Actuarial Analyst II works with a team of actuaries to assist with the actuarial components of health programs, and provides actuarial support to Finance, and/or other departments in the company.

     

    KEY FUNCTIONS/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.

     

    QUALIFICATIONS:

    EDUCATION:

    • Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields.

    EXPERIENCE:

    • At least 2 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis. Commensurate educational experience in related field will be considered.
    • Successful completion of at least 3 or more SOA actuarial exams, preferred.
    • A background in managed healthcare, insurance operations, preferred.

    COMPETENCIES, SKILLS, AND ATTRIBUTES_:_

    • 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.

     

    *Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

    Required Skills Required Experience

  • Qualifications

     

     

    • Develops and implements strategies, practices, and resource allocation programs that are cost effective and ensure the security of Metro Transit’s customers and employees.
    • Researches and develops business models driven by objective analysis of crime and security data, customer and staff feedback, and transit security industry trends and best practices.
    • Communicates Agencies goals and programs internally and externally through actions, spoken and written communication.
    • Identifies and pursues opportunities for enhancing Metro Transit’s security program through enhanced training, coordination, equipment or technology.
    • Manages Metro’s Public Safety staff by creating a positive team environment and providing strategic direction for staff deployment, training, development and coordination with partners.
    • Provides leadership and direction to staff engaged in the development, coordination and implementation of security training programs.
    • Directs the work assignments and outcomes of Metro Public Safety leadership personnel tasked with supervising Metro Public Safety officers and security contractors.
    • Develops and manages contracts with law enforcement partners, and oversees the strategic deployment of law enforcement personnel across the Metro transit system.
    • Acts as a liaison between Metro Transit and law enforcement partners and other first responders.
    • Develops and maintains relationships with governmental and business partners who share an interest in and responsibility for Metro Transit system security.
    • Investigates security incidents across the Metro Transit system, and supports law enforcement investigations of criminal activity.
    • Develops, implements and analyzes Metro Transit’s Security and Emergency Preparedness Plan (SEPP).
    • Prepares, reviews and edits reports and other written material intended for internal and external audiences including Bi-State Development / Metro Transit executive leadership, Bi-State Development Board of Commissioners, governmental partners, and other key stakeholders.
  • Locations
    Charlestown, MA • Boston, MA