Client looking for at least an ASA level health actuary or higher for an individual contributor role. Primarily responsible for researching and determining the likelihood of financial risk to the organization, aligning actuarial documentation with financial reports and tax returns, developing and designing product line evaluations and actuarial models, and assessing, analyzing, and interpreting financial risk and opportunity. This role will focus on Medicaid pricing work, but will also involve capitation rates and ratemaking, data analysis, rate review, contract negotiation, and building out models.
Responsibilities:
Completes actuarial documentation by reviewing and coordinating the actuarial portion of financial reports and tax returns, and responses to insurance regulations; and presenting results internally to mid-level leadership.
Develops and designs product line evaluations by interpreting and communicating findings of analysis of product line financials, reserve, valuation, cash flow analysis; and interpreting product line performance, risk, and assumptions used in product development.
Designs and develops actuarial research by designing complex methods to advance standards, assumptions, and the legal and regulatory environment.
Assesses, analyzes and interprets financial risks and opportunities by using non-traditional actuarial methods and actuarial judgment when conducting actuarial analyses.
Leads collaboration with business partners by translating complex actuarial constructs into actionable recommendations; and developing and formulating accurate actuarial and financial advice in compliance with the Actuarial Standards of Practice.
Creates framework and assumptions for new, existing, and non-traditional actuarial models to meet business needs.
Qualifications:
Bachelors degree in mathematics or related field AND Minimum eight (8) years actuarial experience. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.
ASA required, FSA a plus but not required
Pricing experience is required, but can be in Medicaid, Medicare or Commercial.
Preferred Qualifications:
Two (2) years experience in a leadership role with or without direct reports.
Six (6) years experience with databases and spreadsheets.
Bachelors degree in statistics, actuarial science, mathematics , engineering, or physics.