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Staff Actuary - Medicare

EmblemHealth

Health/Insurer/Manager Level

Staff Actuary - Medicare

EmblemHealth

New York, New York, United States · Remote · Yesterday

Salary
$78k - $149k
Experience
5+ Years

Role Summary

Role type

Pricing partner to product leadership

Closer to a pricing and product strategy role than a reserving cycle role, because performance improvement and premium revenue are central rather than quarterly reporting.

Senior remote Health actuarial role based in New York, focused on Medicare pricing, reserves, rate filings, and risk adjustment. You will lead analytical projects, work with Product Management and Finance, oversee regulatory submissions to CMS and New York authorities, and supervise actuarial staff. The role requires an ASA and at least 4 years of health actuarial experience.

Requirements

Must have

  • Bachelor's degree in Actuarial Science, Mathematics, or related field
  • ASA designation
  • 5-8+ years relevant professional experience
  • 4+ years health insurance actuarial experience, preferably in managed care
  • Strong mathematical and analytical skills
  • Ability to communicate effectively with Business leaders
  • Expert level skills with database, spreadsheet, and analytical software
  • Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.)
  • Capable with data extraction, simulations, automation

Strongly preferred

  • Prior management experience (processes and/or staff)

Nice to have

  • Strong data querying skills using SQL or SAS Enterprise Guide

Skills & Domain

ToolsExcelAccessPowerPointOther_BI_Tool
DomainHealth insurance actuarial experience in managed careMedicare product pricing and rate filingsRisk adjustment and premium optimizationRegulatory filings with CMS and state departments