Actuary - Medicare Stars and Quality

This job is an ASA Certified actuary position that initiates and leads development of advanced actuarial models and analyses specifically focused on forecasting Medicare Advantage Star Ratings. Proactively monitors and analyzes developments and changes to Medicare Advantage Star Ratings methodologies and included measures. Gives direction to less experienced staff and will represent the department's perspectives and needs in cross disciplinary settings. The incumbent will also apply actuarial techniques and statistical analysis in the development and evaluation clinical quality improvement initiatives utilizing a variety of healthcare data sources including claims, enrollment, clinical, HEDIS, and CMS data.

Responsibilities

Initiate and lead development of advanced actuarial models and analyses focused on forecasting Medicare Advantage Star Ratings; Monitor and analyze developments and changes to Medicare Advantage Star Ratings methodologies and measures; Give direction to less experienced staff; Apply actuarial techniques and statistical analysis in development and evaluation of clinical quality improvement initiatives; Define & diagnose problems and outline data requirements for studies; Initiate and lead development of studies, analyses, and presentation materials; Proactively ensure internal and external consistency of work; Utilize internal and external knowledge forums to gain industry perspective; Exhibit understanding of corporate and division goals and values; Independently manage own time and resources across projects; Interact with stakeholders to foster cooperation and teamwork; Engage, motivate, and mentor less experienced staff; Represent department's perspectives and needs in cross disciplinary settings; Other duties as assigned

Requirements

Bachelor's Degree in Actuarial Science, Mathematics, Statistics or closely related field; 5 years Actuarial experience in area of specialization; Associate of the Society of Actuaries (ASA); Possesses and applies a comprehensive and in-depth knowledge of actuarial principles, concepts, practices and processes within multiple fields or disciplines; Possesses significant expertise to complete complex assignments and ability to visualize, articulate, and solve complex problems while leading others to complete complex assignments; Develops, designs, and tests analytic frameworks to solve complex problems using innovative approaches; Assignments are broad in scope and require depth of knowledge as well as ingenuity and originality; Analytical Skills; Oral & Written Communication Skills; Problem-Solving

Nice to have

Pursuing FSA exams towards FSA Certification; Fellow of the Society of Actuaries (FSA)