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Role Summary

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HIGHLIGHTS

Senior health actuarial role (Medicare focus) responsible for pricing, rate filings, and reserve-setting strategies. You will lead projects, coordinate actuarial staff, and work with product, finance, and risk adjustment teams. This is a senior, remote role based in New York.

JOB DESCRIPTION SUMMARY

  • Lead pricing and reserve-setting strategies for Medicare and other health lines
  • Develop and file premium rates with CMS and state regulators
  • Manage and develop actuarial staff responsible for lines like Medicare and Medicaid
  • Collaborate with Product, Finance, and Risk Adjustment on performance analysis
  • Remote role; requires strong Excel/Access skills and experience with data extraction

DOMAIN EXPERTISE

  • health insurance actuarial experience (managed care preferred)
  • premium rate development and regulatory filings (CMS, NY DOH)
  • reserve setting and trend/financial analyses
  • risk adjustment and reimbursement methodologies

KEY REQUIREMENTS

  • Associate of the Society of Actuaries (ASA) and Member of the American Academy of Actuaries required
  • 10+ years relevant professional experience with 5+ years in health actuarial roles
  • Experience with premium rate development and regulatory filings (e.g., CMS, NY DOH)
  • Bachelor's degree in actuarial science/math/related required
  • 1+ year of management experience and ability to develop direct reports

TECH STACK

  • Excel
  • Access
  • PowerPoint
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Role Summary

Loading...

HIGHLIGHTS

Senior health actuarial role (Medicare focus) responsible for pricing, rate filings, and reserve-setting strategies. You will lead projects, coordinate actuarial staff, and work with product, finance, and risk adjustment teams. This is a senior, remote role based in New York.

JOB DESCRIPTION SUMMARY

  • Lead pricing and reserve-setting strategies for Medicare and other health lines
  • Develop and file premium rates with CMS and state regulators
  • Manage and develop actuarial staff responsible for lines like Medicare and Medicaid
  • Collaborate with Product, Finance, and Risk Adjustment on performance analysis
  • Remote role; requires strong Excel/Access skills and experience with data extraction

DOMAIN EXPERTISE

  • health insurance actuarial experience (managed care preferred)
  • premium rate development and regulatory filings (CMS, NY DOH)
  • reserve setting and trend/financial analyses
  • risk adjustment and reimbursement methodologies

KEY REQUIREMENTS

  • Associate of the Society of Actuaries (ASA) and Member of the American Academy of Actuaries required
  • 10+ years relevant professional experience with 5+ years in health actuarial roles
  • Experience with premium rate development and regulatory filings (e.g., CMS, NY DOH)
  • Bachelor's degree in actuarial science/math/related required
  • 1+ year of management experience and ability to develop direct reports

TECH STACK

  • Excel
  • Access
  • PowerPoint

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Job Overview

Salary
Salary not specified
Years of Experience
10+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

A senior health actuary (ASA, MAAA) with 10+ years and strong Medicare/managed care pricing and reserving experience who can lead projects and develop actuarial staff.

ASAOther

Benefits

Shortlist Forming
Closing Soon
67d
67 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Job Overview

Salary
Salary not specified
Years of Experience
10+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

A senior health actuary (ASA, MAAA) with 10+ years and strong Medicare/managed care pricing and reserving experience who can lead projects and develop actuarial staff.

ASAOther

Benefits

Shortlist Forming
Closing Soon
67d
67 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Health/Insurer/Manager Level
EmblemHealth

Senior Staff Actuary (Medicare)

EmblemHealth•New York, United States•2mo ago
RemoteMedicare AdvantageACA ExchangeCommercial Employer HealthMedicaidPricing & RatingReserving & ValuationRegulatory Reporting