Manager & Actuary - Health - 10004
The Manager & Actuary has ownership of all Actuarial pricing and forecasting support relating to Government Market products including Medicare Advantage Individual, Medicare Advantage EGWP, CHIP, Medicare Supplement, and PDP.
· Leads key areas of the Medicare Advantage bid process assuring accuracy in modeling and supporting documentation of assumptions, utilizing best practices from a modeling perspective to optimize team resources.
· Owns annual AOP and reforecasting processes, preparing forecast estimates and explaining variances between pricing and prior forecasting projections.
· Leads analysis on emerging regulations around Government market. Presents findings to Sr. Management.
· Develops an understanding of Medicare Advantage regulations and stays current on proposed changes. Assures pricing processes are in compliance with regulations.
· Assists in filings, pricing, & analysis for CHIP, EGWP, and Medicare Supplement product lines.
· Leads analysis on Medicare Advantage emerging trends in medical cost and population mix.
· Manages 2-4 Analysts: communicates and balances key priorities, delegates work appropriately and provides performance feedback/coaching to the team. Supports analysts to facilitate completion of their exams as well as their actuarial and professional development.
· Works through desk review and audit processes with CMS.
· Bachelor’s degree in Mathematics, Statistics, Economics, Actuarial Services, or related field; or equivalent work experience.
· Fellowship for the society of actuaries (FSA) designation required
· 7+ years of relevant health experience (to include 4+ years in Medicare Advantage bid preparation/desk review).
· Previous experience managing a team.
· Proficiency in Excel, SQL, and BigQuery.