AVP, Actuary-Government Business at EmblemHealth | Acturhire

Role Summary

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HIGHLIGHTS

Senior health actuarial leadership role focused on Medicare and State-Sponsored Programs in New York (hybrid). You will lead the Enterprise Government Actuarial team, own Medicare Advantage bid filings, premium rate filings, pricing assumptions, forecasting, and financial performance across ~400–500k lives. Role emphasizes Medicare pricing strategy, regulatory filings, risk-adjustment forecasting, and people leadership.

JOB DESCRIPTION SUMMARY

Lead pricing and strategy for Medicare and State-Sponsored Program (SSP) lines
Own Medicare Advantage bid filings and premium rate filings with regulators
Manage and develop a high-performing Enterprise Government Actuarial team
Drive forecasting, premium analytics, budgeting, and financial tracking
Hybrid position based in New York supporting enterprise government plans

DOMAIN EXPERTISE

Medicare Advantage pricing and bids
State-Sponsored Program (SSP) regulatory filings
Employer group medical pricing
Risk adjustment forecasting and monitoring

KEY REQUIREMENTS

15+ years actuarial experience with ASA or 12+ years with FSA
10+ years health insurance actuarial experience, preferably Medicare
Proven experience overseeing Medicare Advantage bids and regulatory filings
Demonstrated track record managing large actuarial teams and projects

TECH STACK

Excel
Access
PowerPoint