EmblemHealth

Senior Staff Actuary - Medicare

EmblemHealth • $145K — $175K *
New York, NY 10025In-Person
Finance & Insurance
8 - 10 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in Actuarial Science, Mathematics, or related field required
  • Associate of the Society of Actuaries (A.S.A.) required
  • 10+ years of professional work experience in actuarial roles
  • 6+ years actuarial experience with A.S.A. or 5+ years with F.S.A. required
  • Health insurance actuarial experience, particularly in managed care, is essential
  • 1+ year of management experience required
  • Strong analytical skills with knowledge of reimbursement methodologies required

Responsibilities

  • Provide analytical resources for pricing and reserve strategies
  • Lead projects to assess and enhance current rate structures
  • Coordinate actuarial staff to support affiliate activities
  • Analyze financial performance alongside Senior Product Management
  • Collaborate across the organization to enhance product performance
  • Oversee development and regulatory filing of premium rates
  • Develop and mentor direct reports responsible for specific lines of business

Benefits

  • Opportunities for professional development and advancement
  • Collaborative work environment across multiple departments
  • Exposure to regulatory processes and compliance
  • Leadership experience in managing actuarial teams
  • Involvement in strategic pricing initiatives This role influences significant business decisions
Full Job Description
Summary of Position
  • 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.


Principal Accountabilities
  • 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.


Qualifications

Education, Training, Licenses, Certifications
  • 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.) preferred
  • Fellow of the Society of Actuaries (F.S.A.) preferred


Relevant Work Experience, Knowledge, Skills, and Abilities
  • 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

About EmblemHealth

EmblemHealth is a non-profit health insurance company based in New York City. It is one of the largest non-profit health insurers in the United States, serving over 3 million people. EmblemHealth offers a range of health insurance plans, including HMO, PPO, and EPO plans, as well as Medicare and Medicaid plans. The company also offers wellness programs and disease management services. EmblemHealth was formed in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP). The company has offices in New York City and Albany, New York.
Learn more about EmblemHealth
Size
3,000 employees
Industry
Healthcare
Net Income
-$100 million
Founded
2006
5 Year Trend
-5%
Revenue
$10 billion
NASDAQ
* Ladders Estimates

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