Senior Business Analyst

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Job description

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Responsibilities are project driven and include ownership of specific service metrics, reporting, and analysis that are designed to affect strategic business initiatives and improve and maintain workflow processes and accuracy within the Actuarial and Underwriting Department. This position will also include actuarial and underwriting activities for all lines of business related to producing, reviewing and auditing of proposals, renewals, and funding arrangement settlements.

Essential Responsibilities:

• Maintain Actuarial, Underwriting, and Analytics databases for renewals, proposals and funding arrangement settlements.
• Coordinate the Actuarial and Underwriting Department's system and report needs and serve as a liaison between the department and IT to facilitate data requirements, testing, troubleshooting, and reporting.
• Act as an intermediary with Actuarial, IT, Membership, FBS, GPS, and other stakeholders as required for successful class-plan and PSE rating setup. Common examples of this responsibility would be to act as first contact for questions about premium structures so other departments can proceed with rate setup; provide quality assurance on the work of other departments for which any premiums calculated by the commercial actuarial team are an input; and advise the actuarial team on premium infrastructure limitations during actuarial premium setting.
• Capture appropriate information from mainframe and calculate and prepare renewal reports on specific service metrics, ensures data integrity by auditing accuracy and consistency across organization. Metrics include, but are not limited to, those related to proposal and renewal inventory and delivery and Prism results.
• Apply established formulas and guidelines for timely and accurate rating of existing and prospective insurance contracts
• Maintain and create stored procedures, excel spreadsheets, and other utilities for tasks such as financial reporting, group insurance renewals, enterprise risk management, claims reserves, notice of change letters, and rate filings.
• Set up renewal calculations in Excel; including troubleshooting and updating plan change history, financial arrangements, plan customizations, and renewal notes
• Audit prospective quotes, new groups, and renewals processed enterprise-wide.
• Perform post-renewal audit of plan and rate entry into Facets and PSE systems
• Perform regular audits of group and individual rates, benefits, commissions, client sizes, effective dates, and agent and rep assignments
• Collect and review information to determine group size changes and compliance issues at renewal
• Create and maintain reports as needed for all lines of business
• Stay apprised of all State, Federal, and company policies and regulations. Participate in the review, coordination, application, and communication of regulatory, policy and contract changes.
• Process insurance plan proposals, renewals, alternate and optional quotes, funding arrangement settlements, ASO contracts, and declinations. Make necessary computations from information contained in company software and database applications. Prepare all supportive documentation assemble final information and documents properly, and distribute finished items to the proper individuals.
• Provide information to or request information from, group policy administrators, agents, and other internal or external customers in a prompt, professional, and courteous manner.

Supporting Responsibilities:

• Work with functional teams to improve consistency and drive documentation and process improvements to ensure sustained controls.
• Provide training for Rate Technicians and other Marketing, Sales, and Actuarial, Underwriting, and Analytics staff as needed
• Provide support to the Marketing and Sales Departments, brokers, and agents by offering technical expertise regarding rating and benefit evaluation.
• Provide auditing and backup support for other Actuarial, Underwriting, and Analytics functions when necessary
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Work Experience: At least 5 years experience in the health industry or IT fields, including but not limited to, the preparation of health insurance industry documents and data entry. Demonstrated high degree of confidence and ability to think and work independently. Experience or training in the use of Microsoft Word, Excel, and Windows desirable.

Education, Certificates, Licenses: Bachelor's degree or equivalent (such as an Associate's degree with relevant credentials or applicable work experience) in mathematics, computer science, or a similar emphasis required.

Knowledge: Advanced MS Excel skills required. Proficiency working with Visual Basic for Applications and/or SQL; or otherwise experience with comparable languages or programs such as Python, Ruby, MATLAB, R, or SAS required. Strong math and technical skills. Understands fundamentals of data analysis and interpretation. Ability to identify and define problems, design and then implement solutions, and further monitor results, in a continuous cycle. Requires excellent computer, oral and written communication skills and organization skills; ability to read, analyze and interpret documents and information; and ability to respond to common inquiries and effectively present information to a variety of groups. Ability to deal responsibly with confidential information. Ability to accomplish tasks accurately under pressure, determine priorities, and to meet deadlines. Knowledge of underwriting concepts and ability to employ established rating procedures required. Performs activities with extreme accuracy and attention to details, both subtle and obvious.

Competencies

• Building Customer Loyalty
• Building Strategic Work Relationships
• Contributing to Team Success
• Planning and Organizing
• Continuous Improvement
• Adaptability
• Building Trust
• Work Standards

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team and company growth.
• We actively participate in efforts to improve our many communities-internally and externally.
• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.