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Business Analyst I - Actuarial - Full Time - Days

Maumee, Ohio
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Description

At Paramount, we offer insurance to both large and small groups and also cater to Medicare (Paramount Elite) subscribers in northwest Ohio and southeast Michigan. Our Medicaid product (Paramount Advantage) services those living in the state of Ohio. We maintain an accreditation by the NCQA – the National Committee for Quality Assurance – for our Ohio HMO, Elite and Advantage products. We’re also part of ProMedica, which is ranked the second most integrated health system in the U.S. and No. 1 in the Midwest. For more information about Paramount, please visit our website http://www.paramounthealthcare.com.

 

POSITION SUMMARY

The Business Analyst will evaluate risk of both prospective and existing business opportunities to maximize revenue consistent with corporate goals and standards. Work independently to provide analytic support on projects and proposals.  Assist in the evaluation and implementation of various pricing tools and rate filings

 

ACCOUNTABILITIES

  1. Reviews and evaluates underwriting information and data for prospective groups to calculate proposed rates for less complex cases. Primary group size responsibility is 1-100 contracts
  2. Analyze utilization data and prepare reports for internal and external group presentations.
  3. Research and respond to daily inquiries from Marketing Department
  4. Gathers information, develops options and consults with sales/service to help determine how to best meet the client’s objectives.
  5. Processes new enrollment and final underwriting of individuals and group business. Makes recommendations on process for managing exceptions.
  6. Support the development of new departmental policies and procedures and maintain existing documents to ensure compliance
  7. Ability to work with Big Data - managing several large sources of data including medical and pharmacy claims
  8. Analyze and draw conclusions from large data sets by applying advanced analytical techniques, exploratory mathematics, and sound statistical methods.
  9. Proficient knowledge of database structure and data and reporting tools to facilitate effective data mining

REQUIRED QUALIFICATIONS

Education: Bachelor's degree in business, math, statistics, finance, actuarial science or healthcare administration required

  • Strong knowledge of business intelligence and reporting tools as well as spreadsheet applications required. 
  • Must be adaptable to change, display qualities of initiative and be able to work independently.
  • Proven analytical and communication skills, and the ability to identify customer needs.
  • Ability to plan, coordinates, and organizes multiple priorities while meeting internal and external deadlines.
  • Understands the objectives and the mission of the Actuarial Services Department and ProMedica Health System.
  • Looks for ways to improve internal processes and add efficiencies to daily work activities.
  • Meets all challenges with a positive attitude and resourcefulness.
  • Ability to work independently on multiple projects

 

Years of Experience: Minimum 1-2 years’ business experience

 

 

PREFERRED QUALIFICATIONS

Years of Experience: Minimum of 1-2 years' experience in insurance preferred

 

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

 

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