Amazon.com Services LLC

Healthcare

ActuarialManagerAnalyst

$126–213k San Francisco, California, United States FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Manager candidates.

The Brief

“Actuarial Manager Analyst at Amazon.com Services LLC. Skills: Actuarial reserving, Medical economics, Risk analysis, Medicare Advantage. Analyze Medicare Advantage data. Analyze Accountable Care Organization data”

Industry & Context.

Healthcare
Problems you'll solve

Data analysis; Risk analysis; Financial analysis

What They're Looking For.

Must Have

6+ years data scientist experience, Associate of the Society of Actuaries (ASA), Experience with Medicare Advantage products, Strong knowledge actuarial reserving, Strong knowledge forecasting, Strong knowledge medical economics, Expertise medical claims data, Expertise SQL, Expertise R, Expertise SAS, Expertise Python, Expertise Snowflake, Expertise Tableau/Looker, Ability work cross functionally, Ability communicate effectively stakeholders, Bachelor's degree required

Nice to Have

Fellow of the Society of Actuaries (FSA)

What You'll Do.

Analyze Medicare Advantage data

Analyze Accountable Care Organization data

Design monthly reserving process

Implement monthly reserving process

Estimate Total Medical Expense

Evaluate TME performance

Coordinate TME projections

Support financial processes

Support accounting processes

Support value based care

Support financial risk analysis

Support actuarial support

Support auditor review

Design studies completion factor estimates

Evaluate risk based funding

Evaluate risk scoring performance

Complete evaluation stop-loss coverage

Manage third party vendors

Analyze new to market assessments

Develop new to market modeling

Assess future Medicare expansion

Assess market segment changes

How You'll Work.

Team & Collaboration

Cross functional stakeholders; Finance team; Planning team; Accounting team; Clinical team; Outside auditor review

Communication Scope

Communicate effectively stakeholders

Full Job Description

Amazon One Medical is hiring a Actuarial Manager Analyst. Actuarial rigor is one of the keys to our success. This candidate will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation, and lead continuous evaluation of TME performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical economics reporting and ad-hoc analysis relating to cost of care management -Medicare Risk score projections and premium estimation -Design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation -Lead continuous evaluation of TME performance compared to plan expectations -Coordinate with the finance team on future TME projections that are refreshed monthly and provided quarterly for forecasting and planning -Support month end financial and accounting processes for relevant actuarial estimates. -Value based care contracting support and ongoing financial and risk analysis. -Support ongoing actuarial support for outside auditor review of financial estimates and results. -Design studies to monitor the suitability of the completion factor estimates. -Lead continuous evaluation of risk based funding and scoring performance compared to plan expectations. -Complete the evaluation of stop-loss coverage and manage third party vendors -Analyze and develop new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially) Basic Qualifications: - 6+ years of data scientist experience - Associate of the Society of Actuaries (ASA) is required -Experience with Medicare or Medicare Advantage products -Strong knowledge of actuarial reserving, forecasting and medical econ

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