Manager, Actuarial Job at AvMed Health Plans
Embrace better opportunities.
Are you passionate about health, happiness and helping others? So are we. We’re committed to helping our health plan Members live a happy and healthy lifestyle, and we believe that it starts here first, with our Associates.
At AvMed, we provide the tools and opportunities to enhance, expand, and support each Associate’s personal and professional growth. From tuition reimbursement to exercise classes in the office, embrace a better career with AvMed and join our team!
Position: Manager, Actuarial (Hybrid-local or Remote-out of Territory)
Scope of position: The Manager, Actuarial is responsible for overseeing the Actuarial staff and analytics to develop pricing strategies, and support product development, marketing and sales, revenue optimization, reserve estimation, financial forecasting, segmentation reporting, medical management, and provider contracting analytics.
Essential Job Functions:
- Produces and validates all financial aspects, including ACA risk adjustment for Individual and Small Group product lines, of setting premium rates and develop rate filing exhibits and actuarial memoranda for all product lines.
- Performs financial projections and actuarial analysis to support the design and pricing of existing products, new products and the corporate budget. Ensures accuracy of end results. Extracts, processes, analyzes, and interprets claim experience, premium and enrollment data.
- Assists with training of actuarial trainees, analysts and specialists. Provides assistance to underwriters and marketing in valuing group benefit changes. Reviews underwriting guidelines & policies and suggest improvements to ensure profitability and the avoidance of adverse selection.
- Provides training and user support for Actuarial systems and reporting tools. Recommends and makes improvements in the analytical tools, processes and systems used to support the decision-making needs of the Actuarial team.
- Ensures appropriate pricing and maintenance of existing products as new products are introduced into the product portfolio, including revisions as a result of related new product development.
- Assists in the assessment of feasibility, anti-selection risk, marketability, alternative product options, existing product options, improvements, market needs, configuration issues, and portfolio placement of new products.
- Researches, evaluates and analyzes medical care costs trends by region, market segment, product line, and plan/metallic tier and provide insight as to the cause of any variance with respect to utilization and unit costs.
- Provides analytical expertise and consults with Pharmacy, Finance and Product champions on issues related to pricing, sales strategy, forecasting and financial management.
- Assists management in the coordination of all regulatory audit activities for the Actuarial Department, including Department of Financial Services Market Conduct Exams, Medicare ACR audit, and U.S. Office of Personnel Management audit.
- Plans, coordinates and directs the work activities of staff in the department; works with Human Resources to recruit, interview, select, and hire associates; coaches, mentors and develops staff including overseeing employee onboarding and providing career development planning; manages performance by setting clearly defined expectations and providing ongoing constructive feedback.
- Performs additional duties and responsibilities as assigned by management.
We Offer:
- Competitive Salaries
- Comprehensive Benefits: Medical Plans, Health Savings Account, Dental, Vision, and more…
- Paid Time Off, Company Paid Holidays, Paid Time Off Cash-In
- 401(k)plan with matching contributions, Tuition Assistance, Associate Discounts
You have:
- Bachelor's in mathematics, Economics, Actuarial Services or related field required
- Masters preferred
- 6-10 years of experience working with risk models, mathematical or actuarial analysis, preferably in a health insurance field
- Associate of the Society of Actuaries required
You May Also Have
- Automated or Statistical Analysis Tools- Proficiency: Expert
- Microsoft Office Suite (Excel, Word, PowerPoint, Access)- Proficiency: Expert
- Analytical and Problem Solving- Proficiency: Advanced
- VBA, SQL and/or SAS Programming- Proficiency: Intermediate
Environment:
At AvMed, you will find a family. Our Associates love all the opportunities for advancement, the flexible work environment and team activities. We also encourage our Associates to embrace a life rich in what matters most — health and happiness. We call it being WELLfluent. Join AvMed. Join the WELLfluent!
Location: Location: This position is hybrid 2 days onsite if within local market or 100% remote if outside of local territory.
Miami, Gainsville, Orlando Jacksonville or Tampa.
AvMed is a tobacco/drug free workplace, EOE
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