Actuary, Senior

CareOregon; Washington (District of Columbia); Remote; USD 135,000 - 166,000; Full time

Job summary

An established industry player is seeking a Senior Actuary to lead financial and actuarial analyses that drive strategic decisions and enhance financial sustainability. This role involves evaluating cost trends, optimizing rates, and collaborating with various departments to improve performance. The ideal candidate will have substantial experience in health insurance actuarial roles, particularly in Medicaid or Medicare, and possess strong skills in data management and communication. Join this innovative team and contribute to impactful financial stewardship while enjoying a primarily remote work environment.

Qualifications

• 5+ years in health insurance actuarial roles, preferably with Medicaid or Medicare experience.
• Proficiency in SAS, SQL, MS Excel, and MS Access is essential.

Responsibilities

• Perform financial and actuarial analyses including cost and utilization trends.
• Support rate setting and identify actuarial adjustments to rates.

Skills

SAS

SQL

MS Excel

MS Access

Data Management

Communication Skills

Leadership Skills

Education

Associate of the Society of Actuaries

Fellow of the Society of Actuaries

Job description

Join to apply for the Actuary, Senior role at CareOregon

This senior level position is responsible for performing a wide variety of financial and actuarial analyses impacting strategic decision making and the company’s financial sustainability efforts. Areas of analysis include cost and utilization trend analysis, return on investment evaluations, Medicare bid development, rate setting optimization, forecasting support, benchmarking, risk adjustment optimization, provider payment evaluation, and review of actuarial estimates such as IBNR and PDR. This position provides financial stewardship by identifying opportunities for improved financial performance.

Responsibilities

• Perform financial and actuarial analyses including cost and utilization trends, profitability analytics, and evaluation tools development.
• Support rate setting and identify actuarial adjustments to rates.
• Provide cost and utilization trend recommendations and develop benchmarks for performance assessment.
• Monitor risk adjustment and evaluate provider payment models.
• Prepare risk share reports and drive data-driven strategic decisions.
• Review actuarial estimates and coordinate with outside actuaries.

Qualifications

• Associate of the Society of Actuaries required; Fellow preferred.
• Minimum 5 years’ experience in health insurance actuarial roles; Medicaid or Medicare experience preferred.

Skills & Abilities

• Proficiency in SAS, SQL, MS Excel, and MS Access.
• Strong data management, communication, and leadership skills.
• Ability to analyze complex data, lead projects, and collaborate across departments.

Additional Information

• Work environment is primarily remote, with residence required in one of the specified states.
• Salary range $135,420 - $165,520/year plus benefits and bonus.
• Candidates of color and veterans are encouraged to apply.