Manager, Actuarial (46418)

- Senior

Sunrise, FL

Ambulatory Health Care Services

About the position

Community Care Plan is seeking our Head Actuary to join our strategic finance team. This fast-paced role provides an outstanding opportunity to influence data-driven business decisions. The Actuarial & Strategic Finance team has exposure to all facets of the business and plays a critical role in shaping the future and strategy of the company through forecasting and analysis of key business drivers. This position will have the opportunity to work on non-traditional actuarial projects in a rapidly growing environment.

Responsibilities

• Develop strategies around comprehensive monitoring to efficiently highlight emerging trends.
• Deliver extensive analytical review of various actuarial analyses such as IBNR, trend, rating actions, and valuation work in support of departmental objectives.
• Support junior team members, working with other areas within the Company, producing presentations for senior management and communicating status of deliverables to the department management.
• Improve month-end financial and accounting processes for relevant actuarial estimates.
• Lead continuous evaluation of total medical expense and cohort performance compared to plan expectations.
• Lead cross-business unit and cross-functional projects that significantly impact the Company's decisions around reserve levels.
• Coordinate with finance team projections that are refreshed monthly and provided quarterly for forecasting and planning.
• Value based care contracting support and ongoing financial and risk analysis.
• Actuarial support for outside auditor review of financial estimates and results.
• Design studies to monitor suitability of the completion factor estimates.
• Lead continuous evaluation of risk-based funding and scoring performance compared to plan expectations.
• Analyze and develop new to market assessments and modeling including future expansion and enhancements / changes to other market segments.

Requirements

• Bachelor's Degree
• Fellow or Associate of the Society of Actuaries (FSA/ASA) designation required.
• Minimum of 6 years of experience in the healthcare industry.
• Comprehensive knowledge of actuarial principles, including risk assessment, pricing, reserving, and financial forecasting specific to health insurance products.
• Understanding of healthcare regulations, reimbursement methodologies, and industry trends affecting health insurance, including healthcare reform and emerging technologies.
• Strong organizational and project management skills to effectively prioritize tasks, meet deadlines, and coordinate cross-functional teams in delivering actuarial projects and reports.
• Ability to assess and manage risks inherent in health insurance products, including experience with risk mitigation strategies and decision-making under uncertainty.
• Strong written and verbal communication skills to effectively convey complex actuarial concepts to non-technical stakeholders, including senior management, regulators, and business partners.
• Ability to identify challenges and develop creative solutions to complex actuarial problems, including experience in scenario analysis and sensitivity testing.
• Commitment to staying abreast of industry developments, regulatory changes, and advancements in actuarial methodologies through ongoing professional development and participation in relevant seminars or conferences.

Nice-to-haves

• Advanced decision making and problem-solving skills
• Exceptional team building and employee development skills
• Track record of forming trusted relationships with business leaders
• Demonstrated experience providing proactive guidance to drive business value
• Excellent written and verbal communication skills; ability to tailor messaging to diverse audiences