James Meyer

Experience

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  Elevance Health

  May 2010 - Jan 2016

  Leadership and Mentoring• Colorado Recruiting Lead: responsible for coordinating campus information sessions and interviewing entry level actuarial candidates, evaluating potential talent in cooperation with enterprise recruiting efforts across the country• Intern Mentor: served in a hybrid supervisory and mentor role for Denver office’s student internAnalytics• ACA Reinsurance: subject matter expert, responsible for developing and communicating commercial forecasting, pricing assumptions, ongoing tracking• ACA Risk Adjustment: responsible for contributing to ongoing forecasting efforts, reviewing emerging results given Wakely consulting data (often on tight timelines)• IND/SG member-level reporting: newly responsible for claims projection engine, a crucial piece of a reporting system that allows for run rate and forecast of profitability (after 3R’s) for various cuts by state/segment such as: metal level, sales channel, age/gender, HCC prevalence, risk decile Show less ACA Commercial Business (14 states)• 2014 Pricing: Supported design of pricing model, various pricing assumptions, rate and product disruption analysis (all during the transformative period when emerging ACA regulations were fresh for interpretation and implementation)• 2015 Pricing: Stepped up during a director’s temporary leave and led ongoing development of enterprise pricing model, including: led and presented at open forum check-ins and model training with audiences of 60-70 diverse actuarial staff; coordinated staff support for model changes; contributed to strategy decisions; developed rate increase reporting methodology as per emerging regulation; developed various pricing assumptions• 2016 Pricing: Served as advisor for pricing model improvementsOther• Group Medicare Retiree business (14 states): Supported forecasting model for claims, premium, elements of margin• Predictive Analytics: co-developed a meta-analysis synthesizing the results of ten enterprise advanced analytics projects; this included writing a technical paper distilling complex studies into concise explanations and presenting overall findings to actuarial leadership and non-actuarial audiences Show less

  • Actuarial Analyst III

    Jan 2015 - Jan 2016

  • Actuarial Analyst II

    Jan 2012 - Jan 2015

  • Actuarial Analyst

    Jan 2011 - Jan 2012

  • Actuarial Intern

    May 2010 - May 2011
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  Optum

  Jan 2016 - Jan 2017

  Actuarial Consultant

  Medicare Part D Bids – Trend Forecasts • Supported development of all-in financial trend forecast model Part D AWP Inflation: created model and assumptions for bid from scratch • Client hired Optum for independent opinion and ultimately chose Optum’s recommended trend levels for final bid submission • Developed actual-to-expected reporting for emerging 2017 results Coordination of Benefits Forecasting• Supported development of total COB savings forecasts, including studying each relevant component of trend and anticipating potential improvements to overall methodology Show less

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  UPMC Health Plan

  Dec 2017 - Sept 2020

  Actuarial Associate

  Pricing and Forecasting - Commercial Health Insurance• ACA Pricing: Project managed entire process, organized training for supporting analysts and reporting for management• Developed ACA Pricing Model• Ensured business goals could be met while fulfilling Department of Insurance regulationsInsurance Modeling• Created Member-Level Risk Adjustment Model from scratch, designed for better business analysis by cohorts such as age, area, benefit plan• Created Individual and Small Group projection model, with monthly detail for underwriting experience and annual financial exhibits• Developed relationship with Finance department for smooth reconciliationsRecruiting and Talent Development• Founded actuarial culture committee and office buddy program; supported interviews Show less

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  Elevance Health

  Sept 2020 - May 2021

  Associate Actuary

  Financial Modeling• Network cost discounts: managed model updates for tool that quantified value of the provider network• Directed analysts in updating data for this tool and collaborated with leadership to continue to tailor the tool to client needsClient Presentations• Ensured network cost discount tools could be summarized usefully in client presentations• Presented value propositions of the provider network to internal leaders, external consultants, and business clients Show less