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 environment of belonging that welcomes and supports individuals of all backgrounds.
AVP, Actuarial Science – Medicaid
Location
United States
Posted
7 days ago
Salary
$150K - $300K / year
Seniority
Lead
Job Description
AVP, Actuarial Science – Medicaid
CareSource
• Drive company strategy and manage actuarial expertise in coordination with other leaders on all aspects of CareSource’s actuarial functions. • Oversee actuarial functions and assure the coordination, relevance, and performance in support of CareSource business needs • Hold responsibility for necessary improvements and changes to models, reports, and processes to keep pace with evolving business needs • Support the alignment of Actuarial Services with Finance Department • Support decision making and strategy regarding actuarial inputs to the monthly financial reporting process and reports
Job Requirements
- Bachelor’s degree in actuarial science, mathematics, economics or a related field is required
- A minimum of ten (10) years of experience in the Actuarial Industry with a minimum of five (5) years of management experience is preferred
- A minimum of five (5) years of experience for the actuarial function in Healthcare, including Medicaid, Commercial and/or Medicare Advantage business
- 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
- Experience communicating/presenting to internal senior leaders.
Benefits
- in addition to base compensation, you may qualify for a bonus tied to company and individual performance
- substantial and comprehensive total rewards package
Related Guides
Related Categories
Related Job Pages
More Actuary Jobs
Role Description The Philadelphia Health Department of Milliman is looking for a FSA candidate with a minimum five years of relevant healthcare insurance pricing experience to manage projects for a diverse and expanding client base. Candidates with knowledge of Medicare Advantage or the Affordable Care Act will be given preference. Experience with software development and automation is required. Responsibilities - Develop and apply actuarial models to diverse client situations - Manage client projects - Aid in the development of MAPD bids or ACA filings - Help with the training and management of staff - Assist in software development and automation Qualifications - Bachelors or higher - Five years of experience: Experience with Medicare Advantage or the Affordable Care Act preferred - Experience with software development and automation is required Requirements - Required: FSA Benefits - Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners - Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges - 401(k) Plan – Includes a company matching program and profit-sharing contributions - Discretionary Bonus Program – Recognizing employee contributions - Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses - Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis - Holidays – A minimum of 10 paid holidays per year - Family Building Benefits – Includes adoption and fertility assistance - Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria - Life Insurance & AD&D – 100% of premiums covered by Milliman - Short-Term and Long-Term Disability – Fully paid by Milliman Location This will be a fully remote position. Candidates must be located in the United States. Compensation The overall salary range for this role is $103,500 - $214,820. For candidates residing in: - Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia the range is $119,025 - $214,820 - All other locations the range is $103,500 - $186,800 A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. Equal Opportunity All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran. Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.
Actuarial Analyst, Entry Level
HumanaHumana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
• Provide entry-level actuarial and analytical support for Humana product lines and business areas • Compile, validate, and analyze claims, membership, premium, financial, and operational data • Support pricing, reserving, valuation, forecasting, risk, compliance, and operational analytics • Assist with actuarial models, spreadsheets, dashboards, reports, and recurring analyses • Perform reasonability checks, variance analysis, and actual-to-expected comparisons • Help prepare exhibits, summaries, and documentation for internal reviews, audits, regulatory filings, or business planning • Document data sources, assumptions, methods, calculations, and results • Communicate findings clearly to actuarial team members, leaders, and business partners • Follow actuarial standards, internal controls, confidentiality requirements, and documented procedures • Manage assigned work priorities, meet deadlines, seek guidance when needed, and escalate unusual results or issues • Participate in Humana’s Actuarial Professional Development Program and continue progress toward actuarial credentials
Sr Actuarial Associate
Nationwide InsuranceNationwide Insurance, founded in 1926, is one of the oldest and most well-respected insurance agencies in the United States. Headquartered in Columbus, Ohio, wh
Role Description This role provides portfolio oversight for the E&S/S Programs Planning Unit. Responsibilities include: - Lead program-level profitability reviews and recommend actions on rate, non-rate, mix, and reinsurance. - Own core pricing assumptions and methodologies for assigned programs, aligned to Reserving, Planning, and target CR / PLR. - Build and maintain pricing and monitoring tools (rate/retention, AvE/AvT, segmentation) using BDX and internal data. - Act as a strategic partner to Program Underwriting, CFO, and DDS, turning analytics into clear recommendations and supporting new program vetting. Qualifications - ACAS credential - Background in the MGA/MGU space, reinsurance a plus. - Ability to work independently and solve complex insurance and actuarial challenges. - Entrepreneurial mindset with strong analytical and collaboration skills. Requirements - This role does not qualify for employer sponsored work authorization. Nationwide does not participate in the STEM OPT extension program. - This position can be staffed remotely for potential applicants with critical industry skills and relevant experience. Benefits - Medical/dental/vision - Life insurance, short and long term disability coverage - Paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date - Nine paid holidays - 8 hours of Lifetime paid time off - 8 hours of Unity Day paid time off - 401(k) with company match - Company-paid pension plan - Business casual attire - And more.
• Develop a quarterly, market-level discount review process • Provide meaningful information to the field on the impact and expected timing of new negotiations • Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies • Build a suite of tools and analyses to provide optimal strategic support for Priority Markets and Strategic/Enhanced Providers




