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 requiredTwo to three (2 to 3) years or more of management experience is preferredTwo to three (2 to 3) years or more of actuarial experience is preferredStrong database (SQL, SAS or Access) experience is preferredGeneral managed care or healthcare experience is preferredExperience with Medicare Advantage plans is preferredCompetencies, Knowledge and Skills :
Excellent written and verbal communication skillsExcellent listening and critical thinking skillsStrong interpersonal skills and high level of professionalismAbility to manage, develop, and motivate staffAbility to develop, prioritize and accomplish goals within given timeframesAbility to interact with all levels of management as well as external stakeholdersExcellent problem-solving skills with attention to detailExcellent auditing and peer reviewing skillsAbility to work independently and within a teamAbility to effectively analyze data, develop / maintain appropriate models, draw and report findings and / or conclusions tailored for respective audiencesDemonstrate sound business judgment when drawing conclusions and making recommendationsCommunicate status and results of processes, projects, goals and tasks with leader as needed or requestedExpert proficiency level with Microsoft ExcelAdvanced proficiency with Microsoft Suite to include Word and Power PointAdvanced knowledge and experience coding in SQL, SAS, R, Python or other data manipulation softwareLicensure and Certification :
Associate of the Society of Actuaries (ASA) is requiredFellow of the Society of Actuaries (FSA) is preferredWorking Conditions :
General office environment; may be required to sit or stand for extended periods of timeMay be required to travel less than 10% of the timeCompensation 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 :
Create an Inclusive EnvironmentCultivate PartnershipsDevelop Self and OthersDrive ExecutionInfluence OthersPursue Personal ExcellenceUnderstand the BusinessThis 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 inclusive environment that welcomes and supports individuals of all backgrounds.
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