Sr. Staff Actuary (State Sponsored Programs) - Emblem Health : Job Details

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.

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.

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.) required

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