Sr. Staff Actuary - Medicare

EmblemHealth
United States, New York, New York
Dec 18, 2024
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 Additional Information Requisition ID: 1000002047 Hiring Range: $86,000-$165,000