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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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Actuary – Medical Cost Economics (Remote)

Description

Shape the world of health care by joining UPMC! As a leader in the industry, we are committed to enhancing the lives of all who are a part of our community. Without our employees, we would not be able to innovate health care for our patients and health plan members. From hospitals to our corporate office, all UPMC employees impact our mission of creating life-changing medicine. To continue our tradition of excellence, we are in search of a full-time Actuary to join this community as well.

Click here to learn more about UPMC Health Plan!

UPMC Health Plan is seeking an Actuary in its Department of Health Economics! This credentialed healthcare actuary would drive high-visibility impactful analysis and would be responsible for developing and driving medical cost improvement strategies. This includes analyzing medical cost utilization and unit cost data, identifying top trend drivers and affordability opportunities, and presenting findings to leadership.

The Actuary will require a diverse set of skills and experience, including data and analytics expertise, broad-based business and health economics acumen, a strategic mindset, and an ability to influence and leverage cross-functional teams in a non-traditional actuarial environment.

This position may also direct or supervise less experienced actuarial analysts in the performance of duties.

As an Actuary at UPMC, you will be given support for professional designations through our comprehensive student program and continuing education opportunities. Our team members can choose a work style that is best for them - this position is eligible for fully remote work or a hybrid work arrangement for candidates based in Pittsburgh, PA. 

 

Responsibilities:

  • Lead the development of detailed actuarial and financial tools to communicate drivers of financial performance to facilitate corporate decision-making and the development of cost mitigation strategies.
  • Analyze impacts of healthcare affordability initiatives on medical cost and utilization trends.
  • Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights and deliver results to leadership.
  • Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks.
  • Analyze trends in spending and utilization using healthcare claims data.
  • Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.
  • Guide the development of well-documented standard actuarial reports and projects.
  • Present results of analyses and recommendations to management and senior leaders.
  • Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations.
  • Creatively leverage a wide range of datasets to inform key analyses.
  • Provide direction and supervision to less experienced staff in the performance of duties. May directly manage 1 analyst.
  • Build strong relationships with Actuarial, Analytics, and Finance teams across the enterprise.
  • Ensure that departmental work products meet the highest standards of quality.
  • Provide analytical support for ad hoc data analyses.

 

 

Qualifications

 

  • Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field is required.
  • 5 years of experience in progressively more responsible actuarial work in health insurance/managed care/consulting or equivalent education.
  • ASA certification by Society of Actuaries is required.
  • Actively pursuing FSA certification is preferred.
  • Experience in any of the following is a strong preference: claims-based experience analysis, trend analysis, population health, network and reimbursement analysis,
  • Experience with commercial and government health programs is preferred.
  • In-depth understanding of health insurance market dynamics.
  • Excellent problem-solving and analytical skills.
  • Excellent oral and written communication skills.
  • Adaptability and ability to prioritize effectively.
  • Strong PC skills.
  • Data retrieval skills and relational database experience are required, including SQL and/or SAS.
  • Data visualization experience is preferred.



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


UPMC is an Equal Opportunity Employer/Disability/Veteran

 

UPMC has a Center for Engagement and Inclusion that is charged with executing leading-edge and next-generation diversity strategies to advance the organization’s diversity management capability and its national presence as a diversity leader. This includes having Employee Resource Groups, such as PRIDE Health or UPMC ENABLED (Empowering Abilities and Leveraging Differences) Network, which support the implementation of our diversity strategy.

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   Current UPMC employees must apply in HR Direct

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