• Lead the development and execution of pricing strategies for Group and Supplemental Benefits products (e.g., group life, disability, and voluntary/worksite benefits) • Own pricing assumptions, methodologies, and governance to ensure alignment with profitability and risk objectives • Partner closely with Product, Underwriting, Finance, Distribution, and Claims to support new product development, rate actions, and in-market strategy • Evaluate product performance, emerging experience, and competitive positioning to recommend pricing and product adjustments • Oversee the development, enhancement, and governance of actuarial pricing models • Provide actuarial leadership for rate filings, regulatory compliance, and internal review processes • Present pricing recommendations and business insights to senior leadership and key stakeholders • Lead, mentor, and develop actuarial talent, fostering a high-performing and collaborative team environment • Drive process improvements, automation, and the adoption of advanced analytics in pricing

Title: Staff Actuary - Valuation Location: New York, New York EmblemHealth Job Description: REMOTE Summary of Position - Provide the analytical resources necessary for the development of overall pricing and reserve setting strategies. - Lead projects to analyze current rate structures and develop improvements and alternatives. - Coordinate the actuarial staff as needed to support the activities of the affiliates. Principal Accountabilities - Work closely with Senior Product Management and Finance to analyze financial performance of blocks of business, including membership, trend, and financial analyses. - Identify opportunities to improve product performance in collaboration with all areas of the organization. - Oversee the development and filing of premium rates for all products with the appropriate regulatory authority (e.g., CMS, New York Dep’t of Health). - Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs to increase Emblem’s premium revenue for these segments. - Supervise and develop direct reports accountable for Medicare and State Sponsored areas, as well as other staff. - Regular attendance is an essential function of the job. Perform other duties as assigned or required. Qualifications Education, Training, Licenses, Certifications - Bachelor’s degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required - Associate of the Society of Actuaries (ASA) required Relevant Work Experience, Knowledge, Skills, and Abilities - 5 – 8+ years relevant professional work experience and/or education required - 4+ years health insurance actuarial experience, preferably in the managed care industry required - Prior management experience (processes and/or staff) preferred - A comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required - Ability to communicate effectively with Business leaders required - Expert level skills with database, spreadsheet, and analytical software required - Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.) required - Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred - Capable with data extraction, simulations, automation required Additional Information - Requisition ID: 1000003124 - Hiring Range: $77,760-$149,040 Security Disclosure If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail. Pay Disclosure At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation. EEOC Statement We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law. Sponsorship Statement At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.

• Data manipulation, cleansing and standardization functions for data validation and quality using Microsoft Excel and Access applications • Perform data quality audits of system match results (visual scan and quality review) • Provide analytic support and consultation to core stakeholders related to disruption methodology logic and reporting • Effectively communicate with sales partners to educate them on disruption match logic and methodology

Role Description Shape the world of health care by joining UPMC! As a leader in the industry, we are committed to enhancing the lives of all who are a part of our community. Without our employees, we would not be able to innovate health care for our patients and health plan members. To continue our tradition of excellence, we are in search of a full-time Actuary to join this community. UPMC Health Plan is seeking an Actuary in its Department of Health Economics. This credentialed healthcare actuary would drive high-visibility impactful analysis and would be responsible for developing and driving medical cost improvement strategies, including: - Evaluating program and initiative outcomes. - Interpreting cost and trend driver analysis to generate new initiative ideas. - Presenting findings to leadership. The Actuary will require a diverse set of skills and experience, including: - Data and analytics expertise. - Broad-based business and health economics acumen. - A strategic mindset. - An ability to influence and leverage cross-functional teams in a non-traditional actuarial environment. This position may also direct or supervise less experienced actuarial analysts in the performance of duties. As an Actuary at UPMC, you will be given support for professional designations through our comprehensive student program and continuing education opportunities. Responsibilities - Lead the development of detailed actuarial and financial models to communicate near and long-term projections of financial performance of new and ongoing initiatives and clinical programs. - Analyze impacts of healthcare affordability initiatives on medical cost and utilization trends. - Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights. - Incorporate healthcare claims cost and utilization trends into the development of projections used to define savings methodologies for affordability initiatives and programs. - Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions. - Guide the development of well-documented standard actuarial reports and projects. - Present results of analyses and recommendations to management and senior leaders. - Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations. - Creatively leverage a wide range of datasets to inform key analyses. - Provide direction and supervision to less experienced staff in the performance of duties. May directly manage 1-2 analysts. - Build strong relationships within cross-functional workgroups including Clinical, Pharmacy, Network, Actuarial, Analytics, and Finance teams across the enterprise. - Ensure that departmental work products meet the highest standards of quality. - Provide analytical support for ad hoc data analyses. Qualifications - Bachelor's degree in mathematics, statistics, actuarial science, economics or related field. - ASA or FSA certification. - 5+ years of experience in actuarial work in a health insurance, managed care or related consulting business; or equivalent training, education and/or experience. - Experience in evaluation of medical cost and utilization savings initiatives, statistical techniques for the evaluation of clinical programs, trend analysis, population health, utilization management (UM) / care management (CM) / disease management (DM) analysis is a strong preference. - Experience with commercial and government health programs is preferred. - In-depth understanding of health insurance market dynamics. - Excellent problem-solving and analytical skills. - Excellent oral and written communication skills. - Adaptability and ability to prioritize effectively. - Strong PC skills. - Data retrieval skills and relational database experience are required, including SQL and/or SAS. - Data visualization experience is preferred. Licensure, Certifications, and Clearances - A.S.A. or F.S.A. certification by Society of Actuaries. - Membership in the American Academy of Actuaries. Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.