Assistant Actuary - 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
  • Responsible for supplying assumptions for the budgeting and forecasting processes
  • 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
  • Analyze the impact of existing and forthcoming healthcare reform in Medicare Advantage
  • Track development and accuracy of Medicare risk scores for both EmblemHealth and ConnectiCare
  • Regular attendance is an essential function of the job.  Performs other duties as assigned or required.
     

Qualifications:

 

  • Bachelor’s degree in Economics, Mathematics, or similar major required; advance degree a plus  
  • 4 SOA Exams Passed required
  • Associate of the Society of Actuaries preferred 
  • 5+ years health insurance actuarial experience in Medicare required
  • Advanced understanding of actuarial principles and methodologies required
  • In-depth knowledge of the Health Insurance industry and Medicare Advantage required
  • Excellent mathematical and analytical skills required
  • Strong and effective written and verbal communication required
  • Proficient in the application of spreadsheet software and SAS required
     

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