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.


To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.

Director, Enterprise Valuation (Actuarial)

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Director and Equivalent
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EmblemHealth
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Summary of Position
•    Identify, communicate, and lead organizational dialogue related to healthcare cost/trend opportunities, revenue enhancement opportunities, and risks throughout the organization.
•    Identify medical expense problem areas, and work with Medical Management and Network Operations to determine and implement solutions.
•    Participate as required with Chief Actuary and other areas (CFO and Controller) in the financial management of Emblem Health and affiliated entities.
•    Complete regulatory reporting as required.

Responsibilities:
•    Responsible for establishing valuation and reserve estimates for proper financial accounting.  
•    Establish appropriate reserve methodologies, and perform other analysis as required.  
•    Partner with Finance to ensure appropriate entries are booked, and that variances are analyzed.  
•    Communicate results and implications with senior leaders.  
•    Perform other related projects and duties as assigned.    
•    Establish, document and follow appropriate Policies and Procedures and controls.  Comply with all Model Audit Rule controls.  Manage all audits and reviews, including state, internal and external.
•    Collaborate with Operations, Claims, Medical Management and other areas as necessary to ensure proper data and activities in support of a strong monthly close.
•    Direct, develop, manage and motivate a performance-based actuarial services team.
•    Provide ongoing direction, leadership, evaluation, training and development of staff to maximize return and drive results.
•    Build strong inter-dependent relationships within the organization as appropriate, including finance, network pricing, product pricing, underwriting, and clinical operations functional areas.

 

Requirements:

•    Bachelor's Degree in Actuarial Science/Mathematics/Finance/Healthcare Management or a related field required
•    Associate or Fellow in Society of Actuaries required

•    10 – 12+ years of relevant, professional work experience in positions of increasing responsibility required
•    8 – 10+ years’ experience in actuarial analysis with ASA or FSA; with 3+ years of reserving and planning experience required
•    Excellent quantitative, problem solving and analytical skills required
•    Expertise with MS Office (Word, Excel, Powerpoint, Access, Outlook) required
•    Financial systems experience (PSoft, Oracle, Hyperion, etc.) required
•    SAS experience required
•    Strong communication skills (verbal, written, presentation, interpersonal, negotiation) required
•    Ability to work independently or in a team setting 
•    Ability to successfully prioritize, organize, and manage multiple tasks/projects with competing deadlines
•    Detail oriented, strong analytical and problem-solving ability required
•    Must have advanced understanding of actuarial principles and methodologies
•    Excellent mathematical and analytical skills required
•    Experienced in query and report development using relational database principles 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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