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Risk Analyst III

Location Renton, Washington Job Number 1002965 Date posted 10/05/2021
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Description:
This position works with a team of analysts and actuaries to support premium rate setting, provider contract analysis, network analysis, Medicare bid submissions, underwriting and other financial risks associated with health insurance. The Risk Analyst III builds and maintains analytic models and provides basic analytics. They may work indepently or under the supervision of more experienced analytics.




Essential Responsibilities:



  • Analyze performance of line of business / account / provider: Assess overall LOB/account risk including competitive analysis, broker behavior, network cost profile, legislative and regulatory impacts, payer goals and contributions. Build reports and provide analysis that provide clear, actionable information to clients and/or the organization. Obtain adequate peer review of own work, and provide review for the work of others.

  • Analyze health care data: Evaluate data files and data elements to understand premium, claim, and exposure experience. Evaluate credibility based on population size and prior predictive behavior of the pool / account. Identify potential data issues and research solutions.

  • Development of Actuarial Tools and Data Resources: Create and maintain models (such as rate model and benefit pricing tools) that support the analysis of business strategy and financial risk management. Document models, tools, assumptions and data elements as necessary for compliance and continuity.


Basic Qualifications:

 


Experience



  • Minimum five (5) years of related business/financial experience.

     



Education



  • Bachelors degree in business administration, finance, mathematics, actuarial science or related field OR four (4) years of experience in a directly related field.

  • High School Diploma or General Education Development (GED) required.

     



License, Certification, Registration



  • N/A

     



Additional Requirements:



  • Demonstrated understanding of insurance principles.

  • Demonstrated working knowledge and skills in financial modeling.

  • Familiarity of financial transaction flow within operational and financial systems.

  • Excellent verbal, written and presentation communication skills.

  • Excellent customer service and organizational skills.

  • Ability to identify and solve problems.

  • Demonstrated working knowledge and skills in the analysis of health-care claims data and other related cost.

  • Demonstrated knowledge in analysis of member, purchase, and provider contracting.

  • Proficient in Microsoft Office applications.

     



Preferred Qualifications:



  • Seven (7) years of related business/financial experience.

  • Bachelors degree in business administration, finance, mathematics, actuarial science or related field.


Primary Location: Washington,Renton,Renton Administration - Baker Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 09:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-WA-04|NUE|Non Union Employee Job Level: Individual Contributor Department: Renton Admin Baker - Risk Adjustment Services - 1130 Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.