Actuary, Medicare Advantage

  • 38135
  • Health - Actuarial
  • |
  • Washington, United States
  • |
  • Sep 9, 2020
Insurance
RESPONSIBILITIES
  • Oversees the development of Medicare Advantage bids in the region.
  • Coordinates with the national Part D actuarial team on the development of Part D bids for the region.
  • Collaborates with national and regional business partners to define and execute on the approach to Medicare Advantage bids and analytics and provide attestation to the actuarial soundness of the bids.
  • Participates with other regional Medicare Advantage actuarial leads to direct improvements in capabilities, efficiency, and integration for company’s bid model, documentation, and related actuarial tools.
  • Develops/enhances tools as needed to support product decisions, market strategies, scenario modeling, competitive analysis, experience projections, etc.
  • Collaborates with business partners in Medicare line of business management, product management, regional finance and management, and other departments to obtain and analyze experience data to support bids and other actuarial analysis - includes development of trend and forecast model.
  • Leads quality assurance activities related to source data and bids for Medicare Advantage.
  • Designs and leads studies to improve bid accuracy and justification.
  • Works with other regional and national Medicare actuarial leads to analyze the impact of legislative and regulatory changes on business and financial results.
  • Leads efforts to support Centers for Medicare & Medicaid Services desk review and internal/external audits as applicable with respect to Medicare work.
  • Support the training and development of junior staff.
QUALIFICATIONS
  • Minimum eight years of actuarial experience and ASA or FSA from Society of Actuaries & four years of actuarial experience.
  • Bachelor's degree in mathematics, statistics, computer science, or related field required.
  • Attainment of ASA.
  • Analytical programming experience.
  • Knowledge of core actuarial concepts.
  • Understanding of health care cost structures.
  • Knowledge of key market segments OR knowledge of key government programs.
  • Must be able to work in a Labor/Management Partnership environment
  • Preferred:
  • Progress towards, or achievement of, FSA.
  • 8 years of health actuarial experience.
  • Associate or Fellow of the Society of Actuaries.
  • Member of the American Academy of Actuaries.
  • Strong technical actuarial skills.
  • Medicare Advantage actuarial experience required.
  • Demonstrated ability to communicate and work collaboratively with actuarial teams and non-actuarial business partners.