COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Actuarial Value-based Contracting Analyst IV

Description

UPMC Health Plan's Actuary team is seeking an Analyst IV To support its Value-based Contracting team!

This position applies actuarial knowledge and skills in Medical and Pharmacy cost analysis, risk stratification and adjustment, reserving, trending, etc., in support of value-based contracting work, including identifying issues, data gathering and analysis.  May represent the department on corporate projects. Receives assistance from management when necessary.

This role is REMOTE

Looking for someone who has experience in two of the following realms: Value-based contracting, commercial pricing, Medicare pricing, reserving, medical economics, commercial, Medicaid or Medicare risk adjustment, or Financial forecasting and Analysis. Five years preferred. 

Responsibilities

  • Assists performance measures, associated benchmarks, and other contractual components to include in new formed value-based contracts.
  • Prepares reports for the purpose of evaluating and advising UPMC HP management on the financial impact of proposed provider agreements or changes to existing agreements on an as-needed basis.
  • Analyzes fee-for-service arrangements, contract changes, and project future unit cost trends, calculate values of network relativity factors used in rating and underwriting, evaluate and model alternative payment models (e.g. per diem vs DRG, bundled payments, case rates).
  • Analyzes ACO contracts, PCMH arrangements, Global Capitation, Bundled Rates, Episodic Payments, Capitation, Risk Adjusted Total Cost of Care, and Value Based Payments, review risk/shared savings payouts and accruals.
  • Works closely with Enterprise Risk Management and other key internal stakeholders in areas of risk profiling, risk assessment/analytics, and understanding of key drivers.
  • Acts as an Actuarial Consultant within the UPMC Health System when needed and perform various activities, including IBNR calculations and Data Analysis.
  • Owns project management of projects, including deliverables and appropriate work with a sense of urgency.  Presents results of analyses and recommendations to management when necessary.
  • Documents actuarial methodologies, processes, and results.
  • Peer review of other's work product, direct and supervise junior actuarial department personnel in the performance of duties.
  • Ability to learn new lines of business to help UPMC Health Systems to expand into different arenas such as Stop Loss Insurance or Workers Compensation.
  • Performs in accordance with system-wide competencies/behaviors.
  • Reports to Director or Actuarial Manager of Value-based Contracting team.

 

Qualifications

  • Bachelor's degree in mathematics, statistics, actuarial science, economics or related field and 3+ (five preferred) years of experience in actuarial work in a health insurance, managed care or related consulting business; or equivalent training, education and/or experience.
  • A.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries
  • Excellent problem solving and analytical skills.
  • Good oral and written communication skills.
  • Strong PC skills.
  • Data retrieval skills and relational database experience.
  • Works independently.


Licensure, Certifications, and Clearances:
A.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries

A.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries

  • Associate of the Society of the Actuaries Certificate
  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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