Position Description
As an Actuarial Services Manager, you will be responsible to lead UCare’s rate development for Medicare Advantage and/or individual ACA products. Develop recommendations for UCare’s pricing strategies to product team and senior leadership. Actively participate in cross-functional product portfolio and strategic planning discussions for individual ACA and Medicare lines of business. Train, develop and supervise a team of actuarial analysts. Certify Medicare Advantage and/or ACA Rates. Oversee maintenance and enhancements to existing processes for rate development.
- Manage staff and coordinate the analysis, preparation, and filing of products and premiums, including individual ACA products and Medicare Advantage (Part C). Ensure thorough process documentation is maintained to meet actuarial standards. Manage team to prepare data, projection factors, and required supporting information. Establish and maintain relationships with regulators as it relates to rate and benefit design review.
- Construct and apply actuarial models to solve business questions. Applications include pricing, projection assumption development and impact analysis.
- Perform actuarial studies to monitor financial effect of various portfolio strategies.
- Maintain familiarity with risk adjustment payment models across Medicare and individual ACA lines of business. Understand each component of the revenue stream.
- Maintain familiarity with competitor product benefit packages and premium structure.
- Collaborate with internal and external stakeholders from a variety of backgrounds. Build/Strengthen relationships with stakeholders and understand how actions impact/influence others.
- Exhibit and foster excellent documentation standards.
- Serve as Health Care Economics representative on various ad-hoc work groups. Provide ad-hoc financial analysis as needed.
- Select, train, develop and evaluate staff to ensure desired performance. Establish and communicate clear performance standards across the team, ensuring standardized staff monitoring and performance evaluation.
- Other projects and duties as assigned.
Education
B.S. in Actuarial Science, Statistics, or related field preferred; demonstrated programming/financial analysis experience may be considered in lieu of degree.
ASA or FSA credentialed actuary.
Required Experience
Five years of health industry experience, including experience across multiple lines of business. Experience managing groups of actuaries and analysts.
Preferred Experience
Medicare Advantage bid certification experience. ACA plan filing and certifications. Medicaid experience.
