Sr. Staff Actuary (Medicare)

Company: EmblemHealth
Location: New York
Posted on: May 26, 2025

Job Description:

Remote PositionSummary:

• 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:
    • A bachelor's degree in actuarial science, mathematics, other physical science, or related finance/business degree
    • 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 requiredAdditional Information
      • Requisition ID: 1000002393
      • Hiring Range: $86,000-$165,000 Required
        Preferred

        Job Industries

        • Other

Keywords: EmblemHealth, Hartford , Sr. Staff Actuary (Medicare), Accounting, Auditing , New York, Connecticut