Medicare Stars Actuary: Advanced Modeling Lead

Highmark Health; Cheyenne (WY); On-site; USD 103,000 - 165,000; Full time

Job summary

Highmark Health seeks an ASA-certified actuary to lead development of advanced actuarial models forecasting Medicare Advantage Star Ratings. The role guides analyses across healthcare data (claims, enrollment, CMS) and informs cross-disciplinary decision makers.

The incumbent directs studies, mentors staff, and applies statistical techniques to quality improvement initiatives, aligning with corporate goals and regulatory expectations.

Qualifications

• Bachelor's Degree in Actuarial Science, Mathematics, Statistics or closely related field.
• 5 years Actuarial experience in area of specialization.
• Associate of the Society of Actuaries (ASA) required.
• Fellow of the Society of Actuaries (FSA) preferred.

Responsibilities

• Define & diagnose a problem. Outline data requirements for a study or analysis and devise insightful and creative solutions.
• Initiate and lead the development of studies, analyses, and presentation materials for decision makers.
• Proactively ensure internal and external consistency of all work and perform reasonability checks.
• Demonstrate subject matter expertise and mentor less experienced staff.
• Represent department perspectives in cross-disciplinary settings and negotiate appropriate compromises.

Skills

Actuarial principles

Leadership

Analytical skills

Oral & Written communication

Problem-solving

Education

Bachelor's degree in Actuarial Science, Mathematics, Statistics or closely related field

Job description

Highmark Health seeks an ASA-certified actuary to lead development of advanced actuarial models forecasting Medicare Advantage Star Ratings. The role guides analyses across healthcare data (claims, enrollment, CMS) and informs cross-disciplinary decision makers.

The incumbent directs studies, mentors staff, and applies statistical techniques to quality improvement initiatives, aligning with corporate goals and regulatory expectations.