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.
Sr. Staff Actuary (Medicare) (Remote)
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
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
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/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, 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.