Medicare Actuary Lead: Pricing, Reserves & Strategy

EmblemHealth; New York (NY); On-site; USD 93,000 - 178,000; Full time

Job summary

EmblemHealth is seeking a senior actuary to lead pricing and reserve strategy development and coordinate actuarial resources across affiliates. You will collaborate with Product Management and Finance to analyze performance, refine rate structures, and oversee regulatory filings.

Strong leadership and communication are essential. The role requires extensive actuarial experience, ASA designation, and preferred FSA/MAAA credentials, with oversight of multiple lines of business and mentorship

Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, or related finance/business required.
• ASA certification required.
• FSA/MAAA preferred for advancement.
• Strong mathematical and analytical skills essential.

Responsibilities

• Lead pricing and reserve-strategy analyses and coordinate actuarial resources.
• Analyze financial performance of blocks of business with cross-functional teams.
• Oversee filings of premium rates and costs with regulators (e.g., CMS, NY DoH).
• Collaborate with Risk Adjustment and other departments.
• Mentor and manage staff across lines of business (e.g., ACA, Large Group, Medicare).
• Perform other duties as assigned.

Skills

Actuarial Experience

ASA Certification

FSA Preferred

Management Experience

Analytical Skills

MS Office Proficiency

Reporting to Senior Management

Communication Skills

Reimbursement Knowledge

Mathematics Knowledge

Education

Bachelor’s degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree

ASA required

MAAA preferred

FSA preferred

Tools

MS Office Suite

Job description

EmblemHealth is seeking a senior actuary to lead pricing and reserve strategy development and coordinate actuarial resources across affiliates. You will collaborate with Product Management and Finance to analyze performance, refine rate structures, and oversee regulatory filings.

Strong leadership and communication are essential. The role requires extensive actuarial experience, ASA designation, and preferred FSA/MAAA credentials, with oversight of multiple lines of business and mentorship