Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Assistant Actuary - Farmington, CT or New York, NY Location

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Manager & Professional
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20124 Requisition #
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Assistant Actuary, Valuation, calculates the monthly reserves for GHI and HIP, supports the monthly P&L process with detailed variance testing, collaborates with finance to reflect correct reserves in financial statements, gathers claim inputs and works with underwriting /outside auditor to reconcile reserves.  Also estimates other liabilities including capitated arrangements, Premium Deficiency Reserves and PAD.

 
Responsibilities:
  • Calculate monthly claim reserves for GHI and HIP, collaborating with Finance to reflect correct reserves in financial statements, gathers claim inputs and works with underwriting /outside auditor to reconcile reserves.  Supports monthly P&L process through detailed variance testing.
  • Calculates PAD analysis annually to determine if current percentage is adequate.  Calculates other liabilities which include PDR and Reg 164. Responsible for HCRA submissions. Calculate Seasonality factors.
    Prepare exhibits needed for annual statements and overseeing the preparation of Actuarial reserve certification and summaries.  Prepare the yearly Actuarial Memorandum for Chief Actuary.
  • Answer questions/provide support/gather data inputs for Finance, Underwriting, Claims IT, Provider Contracting, budgeting, external auditors and IRS auditors regarding IBNR estimates.
  • Responsible for Policies and Procedures and SOX documentation.
  • Regular attendance is an essential function of the job.  Performs other duties as assigned or required.

Requirements:

  • Bachelor’s degree in Mathematics, Business or related major required
  • Associate of Society of Actuaries preferred
  • 5+ years actuarial health insurance experience required with experience in valuations preferred
  • Knowledge of pricing methodologies required
  • Experience in data analysis required
  • Excellent written and verbal communicator – need to be able to summarize complex analyses succinctly
  • Actuarial valuation experience required
  • Ability to analyze complex health insurance issues impacting valuations required
  • Ability to communicate with other departments on daily basis to collect data inputs or to respond to questions required
  • Demonstrated ability to learn and adapt
  • Demonstrated team player

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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