Contact: Karen German
Insurance Holdings of America, Inc.
100 Cummings Center Suite 206C
Beverly, MA 01915

phone (978) 927-8855 ext. 1245
fax (978) 922-7431
[email protected]

Harvard Pilgrim Health Care has several positions open in the Claims Department in Boston and Quincy, Massachusetts. We are looking for candidates with the following qualifications:
* Experience in healthcare Customer Service
* Automated claims processing experience as well as CPT4 HCPCS and ICD9 diagnosis coding
* Working knowledge of medical terminology and typing skills of 35 wpm
* Experience handling the adjudication of Member claims

Please forward resumes to:
Harvard Pilgrim Health Care
Attn: K. Kuta (insfile/clms)
10 Brookline Place West
Brookline, MA 02445

Fax: (617) 730-4692
E-Mail: [email protected]

Summary of Position:
The Actuarial, Underwriting, Reporting & Analysis (AURA) has openings for Group Underwriters. Job responsibilities include individual risk assessment and pricing of assigned products (e.g. HMO) under assigned funding arrangements offered to employer groups as defined by Harvard Pilgrim Heath Care underwriting guidelines. Underwriters must be able to assess the risk, understand the strategic implication of the competitive marketplace and the product offerings, make sound underwriting assumptions in the rate development process and be able to thoroughly defend the methodology to clients and their consultants during the rate negotiation process.

Minimum Requirements:
* Bachelor's degree in mathematics, accounting, or finance (Master's preferred)
* A minimum of 3 years of health care underwriting experience, preferably in a managed care environment.
* Ability to negotiate rating and financial proposals effectively
* Must have a solid understanding and appreciation of the interrelated processes within a managed care organization, with particular knowledge of information systems/technology, claims processing, network contracting, medical management, member services, quality assurance, marketing and sales is needed in order to successfully conceptualize, formulate and implement the underwriting strategies needed for product and market share growth.
* Proficiency in electronic spreadsheets is required
* Professional certifications such as a Chartered Life Underwriter (CLU), Chartered Financial Consultant (ChFC), Registered Health Underwriter (RHU), Registered Employee Benefits Consultant (REBC), Certified Employee Benefits Consultant (CEBS) preferred.

Please forward resumes to:
Kristina Patal (insfile/aura)
Harvard Pilgrim Health Care
1200 Crown Colony Drive
Quincy, MA 02169

Fax: (617) 745-1135
E-Mail: [email protected]

Summary of Position:
The Actuarial Analyst is responsible for maintaining the integrity of the department's premium forecast models, automated rating systems and developing rating systems and premium models for the future.
Responsibilities also include making improvements to memoranda and reinsurance rates. In addition, the Actuarial Analyst assists in the development of pricing methodologies, analysis of the Plan's risk pool and identification of trends in HPHC's cost structure.

Qualifications:
Bachelors degree in a quantitatively oriented field such as Business, Mathematics or Finance; 1 to 4 years experience in finance, actuarial or pricing; a solid understanding of underwriting, client reporting and the health care market; excellent math skills; familiarity with financial analysis, statistics and pricing; and excellent interpersonal and communication skills.

Please forward resumes to:
Kristina Patal (insfile/aura)
Harvard Pilgrim Health Care
1200 Crown Colony Drive
Quincy, MA 02169

Fax: (617) 745-1135
E-Mail: [email protected]