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.

Lead Actuarial Analyst - 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.
  • 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.
  • Track development and accuracy of Medicare pricing/budget assumptions and develop actionable items to address variances.
  • Analyze the impact of existing and forthcoming healthcare reform in Medicare Advantage.

Requirements:

  • At least 2 SOA exams passed required
  • Bachelor’s degree in Economics, Mathematics, or similar major required; advanced degrees a plus
  • 2+ years health insurance actuarial experience, preferably in Medicare required
  • Proficient in Excel required
  • Associate of the Society of Actuaries preferred
  • 5+ years health insurance actuarial experience, preferably in Medicare preferred
  • SAS experience preferred
  • Advanced understanding of actuarial principles and methodologies required
  • In-depth knowledge of the Health Insurance industry required
  • Excellent mathematical and analytical skills required
  • Able to communicate effectively in writing and verbally 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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