CareSource
Job Summary :
Medicare role is for an experienced developer of actuarial pricing and forecasting models, specifically for Medicare Advantage plans. The Managing Actuary - Medicare has intimate knowledge of CMS Medicare policy and applies that knowledge to advise the strategic direction of CareSource's DSNP business. The ideal candidate thrives when working in a fast-paced environment with less predictable work and where there is an opportunity to implement new approaches that will become integral to CareSource's financial management of its rapidly expanding Medicare DSNP line of business.
Essential Functions :
Responsible for pricing and forecasting and other actuarial functions including development of key assumptions, as well as evaluation of financial experience and trend drivers
Develop and communicate actionable and strategic recommendations to leadership in support of company goals
Create and maintain new actuarial models to support key business goals and initiatives, such as actual to expected experience reporting, setting monthly accruals for risk adjustment, bid pricing / rate filings, forecasting, and contracting models
Own the actuarial processes being managed (i.e., rate / bid filings, pricing, forecasting, risk adjustment) for the Medicare line of business
Work directly with actuarial consultants within given timeframes to ensure they have all data and assumptions to support annual bid filing as well as several versions of internal pricing
Be able to present work products in a way that is appropriate for leadership and focuses on key decisions needed to sustain product margins
Attention to detail and experienced in rigorous testing of work product
Ability to streamline and automate complex processes
Perform any other job-related instructions as requested
Education and Experience :
Bachelor's degree in actuarial science, mathematics, economics or a related field or equivalent years of relevant work experience is required
Two to three (2 to 3) years or more of management experience is preferred
Two to three (2 to 3) years or more of actuarial experience is preferred
Strong database (SQL, SAS or Access) experience is preferred
General managed care or healthcare experience is preferred
Experience with Medicare Advantage plans is preferred
Competencies, Knowledge and Skills :
Excellent written and verbal communication skills
Excellent listening and critical thinking skills
Strong interpersonal skills and high level of professionalism
Ability to manage, develop, and motivate staff
Ability to develop, prioritize and accomplish goals within given timeframes
Ability to interact with all levels of management as well as external stakeholders
Excellent problem-solving skills with attention to detail
Excellent auditing and peer reviewing skills
Ability to work independently and within a team
Ability to effectively analyze data, develop / maintain appropriate models, draw and report findings and / or conclusions tailored for respective audiences
Demonstrate sound business judgment when drawing conclusions and making recommendations
Communicate status and results of processes, projects, goals and tasks with leader as needed or requested
Expert proficiency level with Microsoft Excel
Advanced proficiency with Microsoft Suite to include Word and Power Point
Advanced knowledge and experience coding in SQL, SAS, R, Python or other data manipulation software
Licensure and Certification :
Associate of the Society of Actuaries (ASA) is required
Fellow of the Society of Actuaries (FSA) is preferred
Working Conditions :
General office environment; may be required to sit or stand for extended periods of time
May be required to travel less than 10% of the time
Compensation Range : $92,300.00 - $161,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type : Salary
Competencies :
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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Essential Functions :
Responsible for pricing and forecasting and other actuarial functions including development of key assumptions, as well as evaluation of financial experience and trend drivers
Develop and communicate actionable and strategic recommendations to leadership in support of company goals
Create and maintain new actuarial models to support key business goals and initiatives, such as actual to expected experience reporting, setting monthly accruals for risk adjustment, bid pricing / rate filings, forecasting, and contracting models
Own the actuarial processes being managed (i.e., rate / bid filings, pricing, forecasting, risk adjustment) for the Medicare line of business
Work directly with actuarial consultants within given timeframes to ensure they have all data and assumptions to support annual bid filing as well as several versions of internal pricing
Be able to present work products in a way that is appropriate for leadership and focuses on key decisions needed to sustain product margins
Attention to detail and experienced in rigorous testing of work product
Ability to streamline and automate complex processes
Perform any other job-related instructions as requested
Education and Experience :
Bachelor's degree in actuarial science, mathematics, economics or a related field or equivalent years of relevant work experience is required
Two to three (2 to 3) years or more of management experience is preferred
Two to three (2 to 3) years or more of actuarial experience is preferred
Strong database (SQL, SAS or Access) experience is preferred
General managed care or healthcare experience is preferred
Experience with Medicare Advantage plans is preferred
Competencies, Knowledge and Skills :
Excellent written and verbal communication skills
Excellent listening and critical thinking skills
Strong interpersonal skills and high level of professionalism
Ability to manage, develop, and motivate staff
Ability to develop, prioritize and accomplish goals within given timeframes
Ability to interact with all levels of management as well as external stakeholders
Excellent problem-solving skills with attention to detail
Excellent auditing and peer reviewing skills
Ability to work independently and within a team
Ability to effectively analyze data, develop / maintain appropriate models, draw and report findings and / or conclusions tailored for respective audiences
Demonstrate sound business judgment when drawing conclusions and making recommendations
Communicate status and results of processes, projects, goals and tasks with leader as needed or requested
Expert proficiency level with Microsoft Excel
Advanced proficiency with Microsoft Suite to include Word and Power Point
Advanced knowledge and experience coding in SQL, SAS, R, Python or other data manipulation software
Licensure and Certification :
Associate of the Society of Actuaries (ASA) is required
Fellow of the Society of Actuaries (FSA) is preferred
Working Conditions :
General office environment; may be required to sit or stand for extended periods of time
May be required to travel less than 10% of the time
Compensation Range : $92,300.00 - $161,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type : Salary
Competencies :
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
#J-18808-Ljbffr