Job Summary:
The AVP, Actuarial Science is responsible for driving and supporting company strategy and managing actuarial expertise in coordination with others to ensure actuarial soundness, and to use actuarial knowledge and tools to help improve profitability of CareSource’s lines of business.
Essential Functions:
- Drive company strategy and manage actuarial expertise in coordination with other leaders on all aspects of CareSource’s rate development and negotiations with the State Medicaid Departments, CMS, and regulators, and to use actuarial knowledge and tools to help improve profitability of the business
- Oversee and assure the coordination, relevance, and performance of actuarial functions in support of CareSource business needs, and hold responsibility for necessary improvements and changes to keep pace with evolving business needs
- Manage continual improvement of actuarial processes and make changes as needed to support the business
- Represent Actuarial Services and CareSource in written and verbal communications, presentations and meetings with regulators, owners and other outside parties regarding matters requiring actuarial expertise
- Support the alignment of Actuarial Services with Finance Department to assure the best possible business intelligence and understanding of company financials in communications to CareSource executive leadership
- Support decision making and strategy regarding actuarial inputs to the monthly financial reporting process and reports, such as claim reserves/accruals, variance analysis, actuarial contributions to Management Discussion & Analysis, etc.
- Implement and maintain actuarial processes and controls consistent with best practices to assure accurate and timely reporting and handoff of actuarial components and inputs to financial reporting
- Perform any other job duties as requested
Education and Experience:
- Bachelor of Science/Arts (BA/BS) degree in Actuarial Science, Mathematics or Finance
- A minimum of ten (10) years of experience in the Actuarial Industry with a minimum of five (5) years of management experience is required
- A minimum of five (5) years of experience for the actuarial function in Healthcare, including Medicaid, Commercial and/or MA business, rate negotiations, design, state and federal reporting requirements, as well as other traditional actuarial functions
- Managed care and state/federal government program experience preferred
- Experience interacting with state or federal regulators, CMS or other external regulatory or auditing entities preferred
Competencies, Knowledge and Skills:
- Excellent PC skills, including advanced Excel, Word and PowerPoint
- Strong analytical skills
- Strong problem solving and critical thinking skills
- Ability to articulate and defend complex ideas and strategies to non-technical audiences
- Collaborative, with the ability to effectively influence others
- Fact-based decision maker
- Experience with using a data warehouse
- Excellent oral, written and interpersonal communication skills
- Strong managerial and team-building skills, with proven track record of hiring and developing high performers
- A proven track record of achievement and integrity
Licensure and Certification:
- Member of the American Academy of Actuaries (MAAA) and Associate or Fellow of the Society of Actuaries (ASA or FSA) is required
- Must maintain memberships in the Society of Actuaries and the American Academy of Actuaries
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation range $150,000-$300,000. CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
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Create an Inclusive Environment
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Cultivate Partnerships
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Develop Self and Others
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Drive Execution
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Energize and Inspire the Organization
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Influence Others
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Pursue Personal Excellence
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Understand the Business
TrueCare is a Mississippi non-profit, provider-sponsored health plan formed by a coalition of Mississippi hospitals and health systems throughout the state and supported by CareSource’s national leadership in quality and operational excellence. TrueCare offers locally based provider services through provider engagement representatives and customer care. Our sole mission is to improve the health of Mississippians by leveraging local physician experience to inform decision-making, aligning incentives, using data more effectively, and reducing friction between the delivery and financing of health care. By doing so, TrueCare will change the way health care is delivered in Mississippi.
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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