Staff Actuary - Medicare

EmblemHealth; New York (NY); On-site; USD 80,000 - 110,000; Full time

Job summary

A healthcare insurance provider in New York seeks an experienced Actuary to analyze financial performance, develop premium rates, and collaborate with various teams. The ideal candidate will have a Bachelor's degree in Actuarial Science, ASA certification, and 5-8 years of relevant experience, particularly in health insurance. This role involves supervising staff and requires strong analytical, communication, and database skills. Competitive compensation and growth opportunities are offered.

Qualifications

• 5 - 8+ years of relevant work experience required.
• 4+ years of health insurance actuarial experience preferred.
• Prior management experience is preferred.

Responsibilities

• Analyze financial performance of business blocks.
• Oversee the development and filing of premium rates.
• Supervise Medicare and State Sponsored staff.

Skills

Analytical skills

Database knowledge

Communication skills

Education

Bachelor's degree in Actuarial Science or related field

Associate of the Society of Actuaries (ASA)

Tools

MS Office Suite

SQL

SAS Enterprise Guide

Job description

• 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.

Responsibilities

• Work closely with Senior Product Management and Finance to analyze financial performance of blocks of business, including membership, trend, and financial analyses.
  
• Identify opportunities to improve product performance in collaboration with all areas of the organization.
  
• Oversee the development and filing of premium rates for all products with the appropriate regulatory authority (e.g., CMS, New York Dep't of Health).
  
• Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs to increase Emblem's premium revenue for these segments.
  
• Supervise and develop direct reports accountable for Medicare and State Sponsored areas, as well as other staff
  
• Regular attendance is an essential function of the job. Perform other duties as assigned or required.

Requirements

• Bachelor's degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required
• Associate of the Society of Actuaries (ASA) required
• 5 - 8+ years relevant professional work experience and/or education required
• 4+ years health insurance actuarial experience, preferably in the managed care industry required
• Prior management experience (processes and/or staff) preferred
• A comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required
• Ability to communicate effectively with Business leaders required
• Expert level skills with database, spreadsheet, and analytical software required
• Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.) required
• Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred
• Capable with data extraction, simulations, automation required