Senior Manager, Actuarial - Risk Adjustment

Acturhire; New York (NY); Remote; USD 164,000 - 215,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

11 paid holidays

Paid sick time

Paid parental leave

401(k) plan participation

Life and disability insurance

Paid wellness time

Job summary

Oscar Health is seeking a Senior Manager, Actuarial - Risk Adjustment to join its Actuarial team. This remote role supports ACA risk adjustment analyses, monthly closes, and forecasting, reporting to the VP of Actuarial.

You will lead AA projects, drive data-driven insights, and help advance risk adjustment capabilities across the organization. The role requires 6+ years of quantitative experience, SOA credentials, and a strong health insurance background.

Qualifications

• College degree or commensurate skills attainment.
• Associate or Fellow of the Society of Actuaries (SOA).
• 6+ years of quantitative analysis experience.

Responsibilities

• Develop Oscar's ability to predict risk scores and ACA market morbidity with cross-functional actuaries and data scientists.
• Source data creatively to improve Oscar and market level risk adjustment predictions.
• Maintain and evolve core risk adjustment reporting and forecast models.
• Conduct research to enhance risk adjustment knowledge, including membership and market comparisons.
• Contribute to monthly closes and ongoing financial forecasts of risk adjustment transfers.
• Analyze drivers of risk adjustment performance and related analyses.
• Lead quarterly audit deliverables and maintain internal control for accurate financial reporting.
• Promote actuarial best practices with emphasis on automation and documentation.
• Maintain relationships with internal and external stakeholders.
• Assist onboarding of analysts into existing processes.
• Ensure compliance with applicable laws and regulations.
• Take on other duties as assigned.

Skills

Quantitative analysis

Education

Bachelor's degree or commensurate skills

SOA Associate or Fellow

Job description

Hi, we're Oscar. We're hiring a Senior Manager, Actuarial - Risk Adjustment to join our Actuarial team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Actuarial Sr. Manager will be a key player in helping Oscar to understand the financial implications to the ACA's risk adjustment program. You will support multiple aspects of the actuarial team's risk adjustment work, including supporting monthly financial close, ongoing forecasting, and various other analyses. This is a very dynamic space, which makes this a great opportunity to work on interesting projects and have a BIG impact.

You will report into the VP, Actuarial.

Work Location:

This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $163,944 - $215,177 per year. The base pay for this role in all other locations is: $147,550 - $193,659 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Live on the cutting edge by developing Oscar's ability to predict Oscar's risk scores and ACA market morbidity, working with a cross functional team of actuaries and data scientists.
• Showcase resourcefulness and creative thinking in sourcing new data for making Oscar and market level predictions in innovative ways.
• Maintain and evolve core risk adjustment reporting and forecast models.
• Conduct research and enhance Oscar's risk adjustment knowledge and capabilities, including views of both Oscar's membership and other carriers in the market.
• Key contributor in estimated risk adjustment transfer estimates for monthly closes and ongoing financial forecasts.
• Conduct various risk adjustment related analyses, including analyzing drivers of risk adjustment performance.
• Lead quarterly audit deliverables and maintain internal control compliance to support accurate financial reporting.
• Promote and shape Oscar actuarial best practices with respect to automation and documentation.
• Maintain strong relationships, rapport, and lines of communication with both internal and external stakeholders.
• Aid in the onboarding of analysts by collaborating and integrating them into existing processes.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• College degree or commensurate skills attainment.
• Associate or Fellow of the Society of Actuaries (SOA).
• 6+ years of quantitative analysis experience.

Bonus points:

• Strongly prefer ACA Risk Adjustment, ACA Pricing/MedEcon, or Non-ACA Risk Adjustment expertise.
• Strong understanding of health insurance concepts and nuances.

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI):

Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([e-mail]) to make the need for an accommodation known.

California Residents:

For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.