Business Analyst
PacificSource

Springfield, Oregon

Posted in Utilities


This job has expired.

Job Info


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.

Position Overview: Act as a liaison between various departments to ensure accurate infrastructure setup. Act as a subject matter expert for enterprise-wide rate implementation. Correctly utilizes approved actuarial rating tables and models for premium determinations in complex business lines. Independently perform audits of billed rates for all lines of business to ensure compliance with state and federal regulations. Serves as first contact to members and sales team to ensure accurate quotations and renewals which includes full quote and renewal documentation support. The Business Analyst II role will offer guidance and support to the Business Analyst I role.

Essential Responsibilities:

  • Perform accurate and complete data extraction from claims data warehouse, including medical, pharmacy and laboratory data sets, to meet project requirements. Maintain and create SQL stored procedures in support of common actuarial services.
  • Diagnose data problems. Work closely with analytics, business intelligence, and IT staff as necessary to resolve them.
  • Work with actuaries and underwriters to maintain and assist in the creation of stored procedures, excel spreadsheets, and other actuarial models for tasks such as financial reporting, group insurance renewals, enterprise risk management, claims reserves, notice of change letters, and rate filings.
  • Create high quality documents to be delivered to internal and external customers.
  • Ensure premiums are correctly implemented enterprise-wide by uploading rates into PacificSource systems.
  • Act as an intermediary with Actuarial, IT, Membership, FBS, GPS, and other stakeholders as required for successful infrastructure 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
  • Periodically audit billed rates for accuracy.
  • Assist with actuarial rate certifications by performing line of business rate audits which are fully compliant with state and federal regulations.
  • Assess premiums for individual, small group, transitional and association business through the accurate use of approved actuarial rate tables and models. Ensure accurate premium portrayal on individual notice of change letter documents.
  • Provide front line support to membership and sales for association and transitional premium quoting and renewals, including full quote and renewal document generation as needed.
  • Perform other underwriting tasks as seasonally appropriate,
  • Engage in other compliance activities as required by various State and Federal laws.
  • Provide information and support in other ad hoc projects.

Supporting Responsibilities:
  • 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.
  • Perform other duties as assigned.

Work Experience: A minimum of 3 years of analytical experience in insurance, healthcare, or a related field is required.

Education, Certificates, Licenses: associate's degree or equivalent in mathematics, computer science, or a similar emphasis required. A Bachelor's degree with a major in mathematics, computer science, or similar subject preferred.

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 solve complex problems. 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.

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

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 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.


This job has expired.

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