Sr. Staff Actuary - Medicare - EmblemHealth : Job Details

Sr. Staff Actuary - Medicare

EmblemHealth

Job Location : New York,NY, USA

Posted on : 2024-12-10T08:51:24Z

Job Description :
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:
  • Bachelor's degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required
  • 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
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