Responsibilities

The Associate Actuary will collaborate with team members and other stakeholders toward delivering needed actuarial services to the organization.

Will work within one of three types of teams with the following responsibilities :

Medicaid Markets

• Provides support for rate advocacy by managing databooks and rate mirroring, rate models, MCO surveys, and other requests.
• Projects and plans for quarterly forecasts utilizing financial forecast models for assigned lines of business.
• Updates forecasting models for reforecasts and expected budgets.
• Determine drivers of medical and pharmacy costs changes.
• Actuarial performance management by tracking current financials and analyzing emerging issues.
• Informs rate setting with validation of Medicaid pricing and ad hoc requests from agencies, working with internal partners as well as external consulting actuaries.
• Developing actuarial models, presentation materials and communicating results of actuarial analyses to various stakeholders.
• Adheres to actuarial standards of practice and the code of professional conduct

Valuation Teams

• Calculates, analyzes, and adjusts monthly reserve according to observed payment patterns, seasonality, and anticipated claim development.
• Identifies underlying drivers of monthly IBNR calculations to be communicated to department and company leadership.
• Calculates monthly LOB membership and revenue, identifying primary drivers of monthly revenue and incorporating new revenue streams into models as needed.
• Prepares summaries of revenue and reserves for LOB finance directors and upper management.
• Provides monthly reserve and revenue data to financial reporting as part of monthly close process.
• Compiles supporting documentation and exhibits for reserve, revenue, and medical loss ratio audits.
• Coordinates preparation of text and exhibits for actuarial opinions and certifications.
• Developing actuarial models, presentation materials and communicating results of actuarial analyses to various stakeholders.
• Adheres to actuarial standards of practice and the code of professional conduct.

Analytics Teams

• Develop analyses that support the identification of meaningful medical and pharmacy cost trends, collaborating with subject matter experts to identify root causes of trends.
• Support the Actuarial team with validation of Medicaid pricing, working with internal partners as well as external consulting actuaries.
• Assist in the development of financial forecasts and projections.
• Support the risk adjustment and IBNR process.
• Participate in strategic discussions and supports strategies for healthy and sustainable growth.
• Developing actuarial models, presentation materials and communicating results of actuarial analyses to various stakeholders.
• Adheres to actuarial standards of practice and the code of professional conduct.

Education / Experience :

• ASA required
• Bachelor’s Degree in Actuarial Science, Mathematics, Statistics, or related field.
• Actuarial Science, Mathematics, Statistics, or related field.
• Minimum 3 years experience in Actuarial field.

Other Skills :

• Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions, and successfully devise / implement solutions calmly and effectively.
• Experience mining large data sets.
• Advanced capabilities in Excel, SAS / SQL, and database applications used for analysis, proficiency with Microsoft PowerPoint.
• Programming experience in Python & R is a plus.
• 4 years’ experience working in health care and / or Medicaid / ACA products.
• Excellent written and verbal communication skills as well as strong data presentation skills.
• Established ability to manage multiple initiatives, shifting back and forth effectively among activities, to produce positive results in a dynamic environment

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential.

We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.

Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Generous paid time off, including holidays and volunteer events.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer paid life insurance, with opportunities to purchase additional coverage.

Employer paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Last updated : 2024-05-24