Sr. Staff Actuary (Medicare)

EmblemHealth; New York (NY); Remote; USD 86,000 - 165,000; Full time

Job summary

An established industry player is seeking an experienced actuary to lead pricing and reserve setting strategies. This remote position involves collaborating with senior management and analyzing financial performance to enhance product offerings. The ideal candidate will have a strong background in actuarial science, with a proven track record in health insurance. Join a forward-thinking company that values analytical expertise and offers a competitive salary range. If you are ready to make a significant impact in the managed care industry, this opportunity is perfect for you.

Qualifications

• 10+ years of relevant work experience in actuarial science or related fields.
• Strong mathematical and analytical skills with a comprehensive understanding of actuarial principles.

Responsibilities

• Analyze financial performance and develop pricing strategies for various business lines.
• Collaborate with product management and finance to improve product performance.

Skills

Mathematical Skills

Analytical Skills

Communication Skills

Actuarial Principles

Management Experience

Education

Bachelor's Degree in Actuarial Science or Related Field

Associate of the Society of Actuaries (A.S.A.)

Member of the American Academy of Actuaries (M.A.A.A.)

Fellow of the Society of Actuaries (F.S.A.)

Tools

MS Office Suite (Word, Excel, Access, PowerPoint, Outlook)

Job description

Remote Position

Summary:

• Provide the analytical resources necessary for the development of overall pricing and reserve setting strategies.


• Lead projects to analyze current rate structures and develop improvements and alternatives.


• Coordinate the actuarial staff as needed to support the activities of the affiliates.


• Lead actuarial staff as needed to support the activities of the affiliates.

Responsibilities:

• Work closely with Senior Product Management and Finance to analyze financial performance of blocks of business, including membership, trend, and financial analyses.


• Work collaboratively with all areas of the organization to identify opportunities to improve product performance.


• Oversee the development and filing of premium rates and/or expected costs with the appropriate regulatory authority (e.g., CMS, New York Department of Health).


• Work closely with Risk Adjustment and other areas.


• Advise and develop direct reports accountable for at least one line of business (e.g. ACA, Large Group, Medicare, Medicaid, SSP), as well as other staff.


• Perform other duties as assigned or required.

Requirements:

• A bachelor's degree in actuarial science, mathematics, other physical science, or related finance/business degree


• Associate of the Society of Actuaries (A.S.A.) required


• Member of the American Academy of Actuaries (M.A.A.A.) required


• Fellow of the Society of Actuaries (F.S.A.) preferred


• 10+ years of relevant, professional work experience and/or education required


• 6+ years of actuarial experience with ASA; or 5+ years' experience with an FSA required


• 5+ years health insurance actuarial experience, preferably in the managed care industry required


• 1+ year of management experience required


• Comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required


• Knowledge of reimbursement methodologies required


• Ability to develop actionable reports for senior management required


• Excellent written and oral communication skills to deliver complex information required


• Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook); data extraction, simulations, automation required

Additional Information

• Requisition ID: 1000002393


• Hiring Range: $86,000-$165,000