Responsible for national actuarial support to the Medicaid business line and to the regional actuaries who support Medicaid in the regions. Client provides Medicaid coverage to over 900,000 members across the program.
Provide actuarial services to develop best-practice actuarial models and promote implementation Program-wide. Maintain accountability for the development of the organization's rate structure, maintenance of adequate reserves, and development of new products. Provide data/analytic expertise to support actuarial services including financial reporting, trend analysis, utilization studies, rate development and claims liability estimates.
• Evaluates product line performance and the risk and appropriateness of assumptions used in product development.
• Initiates and designs high priority primary research activities on behalf of clients.
• Addresses opportunities for process improvements and influencing change.
• Works on projects that require more complex planning and direction setting with diverse and multiple stakeholders.
• Analyzes the financial risks for various asset/liability matching scenarios and monitors the appropriateness of reserves. Serves as an expert on the current health care market.
• Helps identify key gaps in knowledge and needed research for Program and Regions.
• Guides clients away from redundant, non-strategic, cost-ineffective research.
• Sets priorities for all ad-hoc projects and analyses with key clients.
• Assists clients in strategic planning, marketplace analysis, estimating growth potential, product research, image and reputation analysis, brand building, and service performance and improvements.
• Makes initial determinations on reserves, dividend allocations, and surplus forecasts.
• Five (5) years of actuarial experience.
• Bachelor's degree in mathematics, statistics, computer science.
License, Certification, Registration
• Belongs to the Society of Actuaries with the designation of ASA (Associate).
• Ability to manage large, complex projects and oversee multiple projects at the same time.
• Ability to apply advanced actuarial methodologies and their applications to solve business problems.
• Ability to apply advanced principles, theories, and concepts and explain to clients.
• Strong familiarity with the internal and external statistical plans and sources of data, and the use of spreadsheet applications.
• Must be able to work in a Labor/Management Partnership environment.
• Experience in both actuarial and business operations preferred.
• 8 years of health actuarial experience
• Medicaid actuarial experience (three or more years) required
• Fellow of the Society of Actuaries
• Member of the American Academy of Actuaries
• Strong technical actuarial skills
• Demonstrated ability to communicate and work collaboratively with actuarial teams and non-actuarial business partners