Overview
As the Supervisor, Actuary for Medicare Advantage (MA), you will play a pivotal role in leading the actuarial aspects of the MA bid process. You will ensure precision, compliance, and strategic alignment with organizational goals throughout the development and execution of MA bids. Collaborating closely with cross-functional teams, you will drive the formulation of bid packages that meet business objectives and adhere to regulatory standards, ensuring accurate and compliant submissions for successful bid approvals. This position could be remote.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
What You Will Do
- Leads the development and execution of the actuarial aspects of Medicare Advantage (MA) bids, including actuarial assumptions, modeling and forecasting.
- Collaborates with cross-functional teams to develop bid packages that align with business objectives and regulatory guidelines. Ensures accurate and compliant submissions and facilitate successful bid approvals.
- Communicates actuarial findings, assumptions, and recommendations to internal and external MA stakeholders.
- Analyzes and validates data relevant to bid submissions. Reconcile bid data with reported financials to ensure data integrity and accuracy.
- Establishes actuarial frameworks and optimize processes to efficiently interpret MA data, enabling timely and accurate decision-making.
- Provides data and analytical support to Risk Adjustment team, Care Management and other related teams to optimize revenue and manage medical expenses.
- Tracks financial performance of MA products and monitor emerging experience and trends.
- Collaborates closely with reserving actuaries to develop IBNR reserves for MA products.
- Provides guidance and assistance to Accounting department in establishing accruals related to MA.
- Collaborates with internal and external partners to identify MA growth opportunities.
- Identifies business needs and requirement for MA vendor partnerships. Track and evaluate vendor performance and alignment with growth goals.
- Conducts long term projection and ROI analysis for launching new products, expanding into new markets and optimizing existing portfolio.
- Serves as a subject matter expert on actuarial matters related to MA, offering mentorship and training to junior actuarial staff.
- Participates in special projects and performs other duties as assigned.
Qualifications
Licenses and Certifications:
- Associate of the Society of Actuaries (ASA) designation preferred
- Member of the American Academy of Actuaries (MAAA) preferred
Education:
- Bachelor's Degree in Mathematics, Actuarial Science, Statistics or equivalent work experience required
Work Experience:
- Minimum five years of progressively responsible actuarial experience in a Health Plan/ Managed Care organization or similar environment required
- Minimum two years experience specially related to Medicare Advantage bidding required
- Knowledge of core health actuarial processes including Pricing, Valuation, and Budgeting/Forecasting preferred
- Efficiency in manipulating and analyzing large and complex data sets from multiple sources using SAS. Proficient in MS Excel spreadsheets and Visual Basic. Knowledge of Python preferred
- Ability to multi-task required
- Prior experience communicate quantitative analyses and results in a clear, precise and actionable manner preferred
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