We offer remote work opportunities for those residing in the following states ONLY – no other locations are authorized:
AZ, AK, AR, CO, DC, FL, HI, ID, IL, IA, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TX, UT, VA, WA, WI, WY
~Veterans, Reservists, Guardsmen and military family members are strongly encouraged to apply~
Job Summary
Responsible for providing financial reporting of health care costs to Finance team. Calculates and forecasts key parameters in health insurance. Constructs information tables based on analysis of statistical data and other pertinent information in support of financial forecasting to estimate liabilities.
Education & Experience
Required:
• Bachelor’s degree in Actuarial Science, Mathematics, Statistics or related field, or related equivalent experience
• 3+ years of actuarial experience
• Health care or insurance industry experience Strong data analysis, statistics, problem solving and project management experience
• Advanced in MS Excel and proficient in MS Office Suite
Preferred:
• Strong knowledge of CPT, DRG, HCPCS, ICD-9, ICD-10 codes and reimbursement
• Knowledge of healthcare claims processing experience Health care or insurance industry experience
• Society of Actuaries certification
• Knowledge of SQL and data visualization software (e.g. Tableau, PowerBI)
Key Responsibilities
• Provides project leadership regarding Actuarial perspectives and requirements with Data Warehousing and Information Technology projects.
• Works with external actuaries, consultants, and government representatives and other entities dealing with TriWest actuarial data.
• Provides data extraction, manipulation and technical analysis for pricing, reserving, claims cost, and revenue experience studies.
• Compiles, evaluates, and analyzes health care change orders for cost impact.
• Develops monthly IBNR and internal and external management reports and provides interpretative support.
• Provides analysis and recommendations on option year pricing / REA’s / claims.
• Develops and analyzes experience data on medical utilization and provider contracting and discounts.
• Maintains Actuarial Services files and documentation and maintains compliance with TriWest policies and procedures.
• Performs administrative and other duties as assigned.
• Regular and reliable attendance is required.
Company Overview
Taking Care of Our Nation’s Heroes.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Benefits
We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
- Medical, Dental and Vision Coverage
- Generous paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- Paid volunteer time
*Annual base salary for Colorado and Washington State residents: $100,000- $124,000 depending on experience*
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.