Managing Actuary (Medicare)

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:

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 (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• 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 inclusive environment that welcomes and supports individuals of all backgrounds.