Top Actuarial Executive jobs in Toledo, OH

Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based company, headquartered in Toledo, has more than 685 employees dedicated to serving their health plan members.  

Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.

In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.

As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website at paramounthealthcare.com.

REPORTING RELATIONSHIPS/SUPERVISORY RESPONSIBILITIES

No positions report to this position.

POSITION SUMMARY

The position requires a quality-focused and detail-oriented Business Analyst with a demonstrated track record of providing solutions for high-priority business goals and strategic management decisions. The successful candidate will be passionate about data and its value in driving educated business decisions. The candidate will have a consistent track record of success working with large data volumes and work collaboratively with internal teams and external vendors to help Paramount reach strategic financial and membership targets.

ACCOUNTABILITIES

*All duties listed below are essential unless noted otherwise*

• Advanced technical knowledge of analytics, ability to use data sets to conclude, identify trends, and reach credible and solid conclusions through in-house software applications to monitor and report on reinsurance.
• Manage ASO claims threshold submission, payment receipt, distribution, and reconciliation.
• Oversee internal and external reinsurance audits as needed.
• Administer information across the Actuarial teams and other departments to support accurate reporting of reinsurance information for budgeting, rate filings, and financial statements.
• Direct the renewal and prospective reinsurance rate process for existing ASO commercial clients and responsible for coordinating with the Underwriting team to ensure the preparation of complete and competitive proposals.
• Develop and maintain dashboards that represent team metrics and progress toward those goals.
• Manage the relationship with selected reinsurers and external vendor partners.
• Ability to work with Big Data - managing several significant sources of data, including medical and pharmacy claims
• Ability to identify alternative methods of accomplishing defined tasks, especially when obstacles or limitations make the first solution ineffective
• Other duties as required

REQUIRED QUALIFICATIONS

Education: Bachelor’s degree in Business, Economics, Analytics, Finance, or Statistics or relevant experience

Skills:

• Experience with business intelligence applications. Experience with financial statements, rate development, and budgeting.
• Experience using Microsoft Office programs, especially Excel, Word, Access, and PowerPoint. Excellent verbal and written communication skills sufficient to interact with all levels of employees.
• Must be adaptable to change, display qualities of initiative, be able to work independently, and have strong analytical and problem-solving skills.
• Must generate high-quality work products under tight deadlines in a dynamic, fast-paced environment. Demonstrate creativity and be able to develop innovative solutions to business challenges.

Years of Experience: A minimum of 2 years of business experience

License: N/A

Certification: N/A

PREFERRED QUALIFICATIONS

Education: MBA or MHA preferred

Skills:  Experience with Tableau preferred

Years of Experience: Experience in a healthcare setting is preferred

License: N/A

Certification: N/A

WORKING CONDITIONS

Personal Protective Equipment: N/A

Physical Demands: N/A

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio.  For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace