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Bilingual Member Response Agent I

WellSense Health Plan

Bilingual Member Response Agent I

National
Full Time
Paid
  • Responsibilities

    It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

    The Actuarial Analyst I is a key member of the Finance / Actuarial Services team.  Under direct guidance and supervision, the Actuarial Analyst I applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for pricing, reserving, medical economics, financial forecasting, and/or healthcare data analytics. The Actuarial Analyst I 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. 

    Our Investment in You:

    • Full-time remote work
    • Competitive salaries
    • Excellent benefits

    KEY FUNCTIONS/RESPONSIBILITIES:

    • Analyzes financial, statistical and mathematical data and performs actuarial calculations.
    • Assists in the rate development through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin allocation, and projection of future claim cost.
    • Assists in regulatory rate filings, and prepares data or response for additional inquiries.
    • Assists in the development of 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.
    • 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 1 year 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 1 SOA actuarial exams, desired.

    COMPETENCIES, SKILLS, AND ATTRIBUTES:

    • Working knowledge of MS Office products, SQL, and SAS or other statistical software.
    • Should be experienced in Microsoft 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.

     

     

    ABOUT WELLSENSE

    WellSense Health Plan is a nonprofit health insurance company serving more than 440,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.

     

    *WellSense will require proof of COVID-19 vaccination(s) as a term of employment for all employees. The company may make exceptions to this requirement in certain limited circumstances for religious or medical purposes.

    Required Skills Required Experience

  • Qualifications
    • Courtesy, tact, and diplomacy are essential elements of the job.
    • Work involves much personal contact with others inside and/or outside the organization, generally regarding routine matters for purposes of giving or obtaining information which may require some discussion.
    • Bilingual in English/Spanish