Lead Actuarial Analyst - Emblem Health

• 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.

• Work closely with Senior Product Management and Finance to analyze financial performance of blocks of business,
• including membership, trend, and financial analyses.
• Identify opportunities to improve product performance in collaboration with all areas of the organization.
• Oversee the development and filing of premium rates for all products with the appropriate regulatory authority (e.g.,
• CMS, New York Dep't of Health).
• Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs to increase
• Emblem's premium revenue for these segments.
• Supervise and develop direct reports accountable for Medicare and State Sponsored areas, as well as other staff
• Regular attendance is an essential function of the job. 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 (ASA) or Fellow of the Society of Actuaries (FSA) required
• Member of the American Academy of Actuaries (M.A.A.A.) preferred
• 5 - 8+ years relevant professional work experience required
• 4+ years health insurance actuarial experience, preferably in the managed care industry required
• Prior management experience (processes and/or staff) preferred
• A comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required
• Ability to communicate effectively with Business leaders required
• Expert level skills with database, spreadsheet, and analytical software required
• Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.) required
• Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred
• Capable with data extraction, simulations, automation required
• Ability to navigate across multiple organizational lines and business and functional units to identify, analyze and quantify healthcare data sets required
• Knowledge of reimbursement methodologies required

Additional Information

• Requisition ID: 220HG