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Position: Actuarial Consultant
Institution: Aetna, Inc.
Location: Hartford, Connecticut, United States
Duties: This individual will work as a medical and pharmacy benefit subject matter expert on a team of experts. The team is responsible for translating benefits coded as BIC/Provision/Line Value/Remarks/Dictionary items under the legacy systems (BPLV) into the FOV format needed for rating. For new, unusual, and complex coding issues, the individual will be required to do independent research and recommend solutions. Correct interpretation of the benefit information contained in the legacy system coding and an understanding of how the information is needed in rating is necessary
Requirements: Bachelor's degree or equivalent experience
   
Text: Actuarial Consultant Job Group Actuarial EEO Statement Aetna is an Equal Opportunity, Affirmative Action Employer Req# 38997BR Primary Location CT-Hartford Locations CT-Hartford Percent of Travel Required 0 - 10% Potential Telework Position Yes Full or Part Time Full Time Supervisory No Job Description POSITION SUMMARY This individual will work on a team that produces monthly health plan benefit indexes (financial relativity values) used by actuaries across all commercial segments in Aetna and the middle and large market rating system. In addition to creating benefit indexes for all commercial segments medical and pharmacy business, the team is responsible for managing the large data and suite of tools used in the process. FUNDAMENTAL COMPONENTS This individual will work as a medical and pharmacy benefit subject matter expert on a team of experts. The team is responsible for translating benefits coded as BIC/Provision/Line Value/Remarks/Dictionary items under the legacy systems (BPLV) into the FOV format needed for rating. For new, unusual, and complex coding issues, the individual will be required to do independent research and recommend solutions. Correct interpretation of the benefit information contained in the legacy system coding and an understanding of how the information is needed in rating is necessary. Attention to detail and translation guidelines is required, and on-time delivery of translations each month is critical. Candidates should have a minimum of 1 year of experience with either BPLV or FOV coding. Experience with both is highly desirable. Experience with AQC rating is also highly desirable, but is not an absolute requirement for a candidate who has a solid understanding of benefits values and is strong in working with data. Ability to work independently and solve problems with little supervision is the key to being successful in this position. BACKGROUND/EXPERIENCE DESIRED Actuarial or Underwriting experience and/or solid knowledge of rating systems/methods, plan set-up, or product design. Experience in using MS Excel, MS Access and accessing data in SQL databases. 1 year(s) experience is desired. EDUCATION The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. REQUIRED SKILLS General Business/Demonstrating Business and Industry Acumen/FOUNDATION General Business/Turning Data into Information/FOUNDATION Leadership/Collaborating for Results/FOUNDATION DESIRED SKILLS General Business/Communicating for Impact/FOUNDATION Technology/Leveraging Technology/FOUNDATION ADDITIONAL JOB INFORMATION Candidates must have knowledge of health care benefits, Aetna products and at least one of the following: - Knowledge of the PE/RS coding system - ACAS claim payment system - Knowledge of the FOV coding system - Aetna plan setup procedures Candidates must have the ability to: - read and interpret benefit information contained in the line value text - work on a small team which requires that at least two members of the team be working during regular business hours - work under tight deadlines and be flexible to embrace changing business priorities Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Employment Type Regular Career Band Description Professional
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