Government Consulting I - External
MMC

Minneapolis, Minnesota

Posted in Consultancy


This job has expired.

Job Info


Mercer Health & Benefits, LLC is seeking candidates for the following position based in the Minneapolis, MN office:

Government Consulting I

We will count on you to:

Provide statistical analysis in specific business areas on various actuarial and financial projects in connection with government sponsored health and welfare programs. Liaise with project leaders to scope data aspects for each project to determine the best framework for the data model. Summarize critical statistical datasets from multiple internal and external data sources in order to validate and enter the data into data models within our internal databases, including Excel, Access and SAS EG. Responsible for building and expanding upon existing complex data models in our internal databases. Engage in development activities to ensure that project data models are flexible and broad enough to allow adjustments and changes at various phases of a project. Develop supplemental ad hoc statistical analysis as needed. Function as a subject matter expert for pharmacy-related reimbursement data structures. Assist with development of new reimbursement models in conjunction with client leads and transfer these models to SAS EG or other advanced applications. Validate client data in Access or SAS EG to ensure pharmacy claims are submitted completely and correctly, and claim quantities and dollars are within expected range. Run statistical analysis on pharmacy data and run comparison review with pricing benchmarks to assess payment efficiency of pharmacy data and predict trending in pharmacy claim payments, for the purpose of actuarial rate setting for future years. Develop and run SAS EG programs to regularly update (weekly/monthly/quarterly/annual) the pharmacy reimbursement rates for state Medicaid program. Work on actuarial projects to evaluate the impact of the expected program changes and/or incurred but not reported (IBNR) claims on Medicaid program cost, and reconcile the differences between the projected rates and the reported claim costs.

What you need to have:

Must have Bachelor degree or foreign equivalent in Actuarial Science, Applied Mathematics, or a related field plus three (3) years of experience in the position offered, as an Actuary, Government Consulting Pharmacy Analyst, Clinical Review Technician, or a related position. Must have one (1) year of experience with: Excel (pivot table, macros, rate model building and documentation, graphing, formula auditing); Access; FirstDataBank and MediSpan specifications; pharmacy claims payment processing; medical claim payment processing; pharmacy efficiency and benchmarking analyses; pharmacy reimbursement practices; pharmacy claim model development; data cleaning, preparation, validation and structuring; data visualization; SAS EG; actuarial trend and rate setting processes; and pharmacy reimbursement rate setting model development.


This job has expired.

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