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About the job

This individual contributor role is responsible for developing, maintaining, and enhancing Excel-based Medicare pricing models, with a primary focus on Employer Group Waiver Plan (EGWP) products for Medicare Advantage and Part D populations across multiple geographic markets. This role will use these models to support EGWP pricing, forecasting, and financial analysis activities that inform business and product strategy. In addition, this role will design and develop tools and methodologies to evaluate the financial risk and opportunity to the organization from Medicare policy changes, government proposals, regulations and reimbursement updates.

Job Summary:

This individual contributor is primarily responsible for researching and determining the likelihood of financial risk to the organization, preparing and reviewing actuarial documentation for accuracy, and conducting product line evaluation, actuarial modeling, and financial risk and opportunity analyses.

Essential Responsibilities:

Pursues self-development and effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and customers; influencing others through technical explanations and examples; providing occasional mentoring to team members; listening and responding to, seeking, and addressing performance feedback; creating plans to capitalize on strengths and develop weaknesses; anticipating and responding to the needs of others; and adapting to and learning from change, difficulties, and feedback.

Completes work assignments by applying up-to-date expertise in subject area to generate creative solutions; ensuring all procedures and policies are followed; leveraging an understanding of data, and resources to support projects or initiatives; collaborating cross-functionally to solve business problems; identifying and monitoring priorities, deadlines, and expectations; communicating progress and information; identifying, recommending, and implementing ways to address improvement opportunities; and escalating issues or risks as appropriate.

Supports actuarial documentation by preparing and reviewing for accuracy and reasonability the actuarial portion of financial reports and tax returns; and responses to insurance regulations.

Participates in product line evaluations by conducting analysis of product line financials, pricing, reserve, valuation , cash flow analysis; and analyzing product line performance, risk, and assumptions used in product development.

Stays abreast of actuarial research by examining developments in standards, assumptions, competition, and the legal and regulatory environment.

Assesses, analyzes and interprets financial risks and opportunities by applying actuarial methods; and conducting actuarial analyses.

Supports collaborations with business partners by understanding the business needs; translating actuarial constructs into non-technical recommendations; and complying with the Actuarial Standards of Practice.

Supports actuarial modeling by developing and enhancing actuarial models; assisting with the development of alternative assumptions and forecasts using in-house models or actuarial software; and assisting with validating the data and results.