Note: The job is a remote job and is open to candidates in USA. EmblemHealth is seeking a hands-on Medicare Actuary to support pricing, forecasting, and bid development for Medicare Advantage, Part D, and EGWP products. The role focuses on bid season execution, Medicare forecasting, and delivering analytics to inform pricing and product strategy.
Responsibilities
- Own actuarial components of the annual Medicare Advantage and Part D bids, including benefit pricing, trend, risk score assumptions, admin load, and margins
- Be a collaborative partner across teams by pricing product scenarios
- Review ongoing CMS releases and refine assumptions to monitor a rapidly changing landscape
- Deliver regular forecasting with clear drivers, risks, and variances vs. plan/budget
Skills
- Bachelor's degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required
- Associate of the Society of Actuaries (ASA) required
- 5 – 8+ years relevant professional work experience and/or education required
- 4+ years health insurance actuarial experience, preferably in the managed care industry required
- A comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required
- Ability to communicate effectively with Business leaders required
- Expert level skills with database, spreadsheet, and analytical software required
- Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.) required
- Capable with data extraction, simulations, automation required
- Prior management experience (processes and/or staff)
- Strong data querying skills using tools such as SQL or SAS Enterprise Guide
Company Overview
EmblemHealth is an insurance and wellness company that offers health benefits to consumers, employers, and government purchasers. It was founded in 1937, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is http://www.emblemhealth.com.