Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY 
The Actuarial Analyst is an entry-level professional supporting actuarial processes across Community Health Choices' lines of business, including ACA Marketplace, Medicare Advantage, and Medicaid. Under the guidance of senior actuarial staff, this role assists with data preparation, claims and utilization monitoring, risk score tracking, and regulatory filing support. 

The Actuarial Analyst works collaboratively to ensure data integrity and contribute to ongoing actuarial and financial projects. This position serves as a foundational development opportunity for individuals pursuing a career in healthcare actuarial science

JOB SPECIFICATIONS AND CORE COMPETENCIES
 

Data Preparation & Claims Monitoring: 
Assist with preparing claim triangles and enrollment files to support IBNP reserve development. Monitor claims trends and utilization patterns to identify variances across product lines. Track member risk scores to support risk adjustment and predictive modeling efforts.
 

Support for Actuarial Filings & Budget Planning: 
Provide support for regulatory filings including the Statement of Actuarial Opinion, ACA rate submissions, and Medicare bid components. Assist in budget development by compiling utilization data and supporting documentation.
 

Collaboration, Documentation & Learning: 
Collaborate with senior staff and cross-functional teams to gather and analyze data. Contribute to process documentation and knowledge management. Participate in professional development to build foundational actuarial competencies.
 

Other duties as assigned to support departmental and enterprise objectives.

Reports to Position Title: Actuarial Director

QUALIFICATIONS: 
Education/Specialized Training/Licensure: 
'    Bachelor's degree in actuarial science, Mathematics, or related field.
'    2 or more Society of Actuaries Exams passed required.

Work Experience (Years and Area): None; Entry Level
Management Experience (Years and Area): N/A


Software Proficiencies: 
'    Microsoft Excel and SQL

Job Title Competencies
'    Analytical Thinking
'    Motivated
'    Results Oriented
'    Taking Initiative
'    Exceptional written and verbal communication
 

Application Instructions

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