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 - Medicare

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Manager & Professional
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EmblemHealth
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  • Provides actuarial services in support of Medicare business.
  • With specific responsibilities of Medicare rate filing for both EmblemHealth and ConnectiCare
  • Additional responsibilities of financial performance tracking and trend analysis

Responsibilities:

  • Participates in product development, pricing, and rating implementation of new and existing Medicare business, including support in the filing of Medicare Advantage bids for both EmblemHealth and ConnectiCare
  • Supports analysis of inpatient facility, outpatient facility and professional claims experience, measures utilization levels and trends, evaluates cost and intensity levels and trends, and performs various other actuarial and mathematical analyses
  • Responsible for supplying assumptions for the budgeting and forecasting processes
  • Supports analysis of drug claims experience, measures utilization levels and trends, evaluates cost and intensity levels and trends, and performs various other actuarial and mathematical analyses
  • Analyze the impact of existing and forthcoming healthcare reform in Medicare Advantage
  • Track development and accuracy of Medicare risk scores for both EmblemHealth and ConnectiCare
  • Regular attendance is an essential function of the job.  Performs other duties as assigned or required.
     

Qualifications:

 

  • Bachelor’s degree in Economics, Mathematics, or similar major required; advance degree a plus  
  • 4 SOA Exams Passed required
  • Associate of the Society of Actuaries preferred 
  • 5+ years health insurance actuarial experience in Medicare required
  • Advanced understanding of actuarial principles and methodologies required
  • In-depth knowledge of the Health Insurance industry and Medicare Advantage required
  • Excellent mathematical and analytical skills required
  • Strong and effective written and verbal communication required
  • Proficient in the application of spreadsheet software and SAS required
     

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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