AVP, Actuarial Science (Medicaid)

Job Summary:

The AVP, Actuarial Science, is responsible for driving and supporting company strategy and managing actuarial expertise in coordination with others to ensure actuarial soundness, and to use actuarial knowledge and tools to help improve profitability of CareSource’s lines of business.

Essential Functions:

• Drive company strategy and manage actuarial expertise in coordination with other leaders on all aspects of CareSource’s actuarial functions. This includes pricing, forecasting, month-end close activities, and performance monitoring and explanations. Uses actuarial knowledge and tools to help improve profitability of the business area(s) they oversee.
• Oversee actuarial functions and assure the coordination, relevance, and performance in support of CareSource business needs
• Hold responsibility for necessary improvements and changes to models, reports, and processes to keep pace with evolving business needs
• Manage continual improvement of actuarial processes and make changes as needed to support the business
• Represent Actuarial Services and CareSource in written and verbal communications, presentations and meetings with regulators, owners and other outside parties regarding matters requiring actuarial expertise
• Support the alignment of Actuarial Services with Finance Department to assure the best possible business intelligence and understanding of company financials in communications to CareSource executive leadership
• Support decision making and strategy regarding actuarial inputs to the monthly financial reporting process and reports, such as claim reserves/accruals, variance analysis, and actuarial contributions to executive leadership reports
• Implement and maintain actuarial processes and controls consistent with best practices to assure accurate and timely reporting and handoff of actuarial components and inputs to financial reporting
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree in actuarial science, mathematics, economics or a related field is required
• A minimum of ten (10) years of experience in the Actuarial Industry with a minimum of five (5) years of management experience is preferred
• A minimum of five (5) years of experience for the actuarial function in Healthcare, including Medicaid, Commercial and/or Medicare Advantage business; rate negotiations, process/model/report design, state and federal reporting requirements, as well as other traditional actuarial functions
• Managed care and state/federal government program experience preferred
• Experience interacting with state or federal regulators, CMS or other external regulatory or auditing entities preferred
• Experience communicating/presenting to internal senior leaders

Competencies, Knowledge and Skills:

• Excellent strategic planning and process design skills
• Excellent PC skills, including advanced Excel, Word and PowerPoint
• Strong analytical skills
• Strong problem solving and critical thinking skills
• Ability to articulate and defend complex ideas and strategies to non-technical audiences
• Collaborative, with the ability to effectively influence others
• Fact-based decision maker
• Excellent oral, written and interpersonal communication skills
• Strong managerial and team-building skills, with proven track record of hiring and developing high performers
• A proven track record of achievement and integrity
• Strong grasp of business processes, operations, and other business partner competencies

Licensure and Certification:

• Member of the American Academy of Actuaries (MAAA) and Associate or Fellow of the Society of Actuaries (ASA or FSA) is required
• Must maintain memberships in the Society of Actuaries and the American Academy of Actuaries

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• May be required to travel less than 20% of the time

Compensation range $150,000-$300,000.  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

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Energize and Inspire the Organization

• 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.