** Senior Actuary** - Healthcare/Health Plan

Arcadian & Position Summary: 
 

Arcadian Management Services (Arcadian) and its Health Plan affiliates is a fast growing, $400+ million revenue, stable healthcare company focused on providing value based benefits to senior citizens in underserved markets.  Arcadian is building a financial analysis and analytics team to support its efforts in evaluating the Medical Economics and margin preservation for the company.   Arcadian seeks to add actuarial sciences expertise.

The Senior Actuary is responsible for overseeing Arcadian’s direction concerning strategic positioning of its benefit plan design to be competitive yet adequately administrable, generating appropriate and consistent margins.  The Senior Actuary will be involved in setting goals for margin by market, the composite at the company level and coordinating benefit plan design, bid process, analyzing operating results and performance, reviewing lag/IBNR analyses, analyzing competitive positions and product offerings.

The Senior Actuary will consult across all areas of Arcadian that impact benefit offerings, plan design, gross margin preservation.  The Senior Actuary will work with the data available to develop analytics and make recommendations that assist Executive Management in making strategic and operational data-based decisions.  The support is provided by delivering timely, accurate and relevant data analysis and financial information concerning benefit design and implications. 

The Senior Actuary will have a significant role in setting Arcadian’s overall strategy and will provide insight and informational guidance to the Executive Management Team as they set strategic goals and effectuate implementation plans. 

This position interfaces with Health Services, Sales & Marketing, Medical Economics and Finance (including the strategic financial plan, budgets, forecasts, and monthly analysis of results). 

Primary Duties and Responsibilities:

• Interface effectively with other Departments as needed to accomplish above objectives, working collaboratively

   

• Coordinate with Sales & Marketing and Medical Economics regarding assessment of market conditions, competitive offerings and associated financial implications to competitors

   

   

• Develop advice around benefit plan offerings.

   

   

• Monitor success and performance of current offerings to make appropriate suggestions regarding modifications

   

   

• Track legislative and market conditions that can and should impact Arcadian offerings.

   

   

• Assist in tracking medical cost trends – interfacing with Finance and Medical Economics

   

   

• Assist in review of performance around claims payments and other medical costs – including implications and determination of lag/IBNR amounts

   

   

• Work with existing (or as necessary develop, build and analyze) financial models, business line and geographic market and product profitability analyses; Present results of analysis to financial and business leaders including senior management

   

   

• Analyze monthly healthcare revenue and cost trends including utilization by market and specialty, PMPMs and gross dollar changes to identify unusual situations or opportunities for intervention, coordinating with Finance and Medical Economics teams

   

   

• Participate in the database tracking and management, development and maintenance of performance metrics, measurements, methods, and targets.

   

   

• Provide insights and suggestions on the use and interpretation of analysis, reports, methodologies, systems and source data.

   

   

• Work closely with Finance senior management to improve financial analysis, reporting, budgeting, and forecasting processes.
• Monitor trends and changes in the actuarial field and healthcare industry and communicate findings to management and associates

Minimum Qualifications:

• Actuarial training and appropriate level of licensure.

   

• 5+ years relevant experience, including experience with healthcare, budgeting and an application of varying IBNR methodologies.

   

   

• 8+ years health care specific actuarial and financial analytic experience.

   

   

• CMS Medicare Advantage bid design and submission experience

   

   

• Strong analytical and problem solving skills.

   

   

• Advanced knowledge of Microsoft Excel.  Strong familiarity with Access and SQL desired.

   

   

• Excellent communication skills both oral and written.

   

   

• Ability to work effectively in a team environment and independently perform individual tasks within a project.

   

   

• Proven ability to carry a complex project from start to finish including appropriate coordination and utilization of a team and a presentation to senior management containing actionable information.

   

   

• Health plan experiences required.  Medicare Advantage experience is highly preferred.

   

  Appropriate professional actuarial certifications that are active and in good standing with the Society of Actuaries.

Benefits & Compensation:

• We pay a competitive compensation & offer growth opportunities
• Our benefits include HMO & PPO options for health, dental and vision
• We also offer a 401k matching program, Employee Referral Program and other excellent benefits.

** Please submit salary history/requirements when applying! **