Job Description

Position Summary:

Community Care Plan is seeking our Head Actuary to join our strategic finance team. This fast-paced role provides an outstanding opportunity to influence data-driven business decisions. The Actuarial & Strategic Finance team has exposure to all facets of the business and plays a critical role in shaping the future and strategy of the company through forecasting and analysis of key business drivers. This position will have the opportunity to work on non-traditional actuarial projects in a rapidly growing environment.

Responsible for implementing detailed analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions, developing complicated models and performing detailed analysis of the results. Developing presentations that provide information for decision making. Understanding business and actuarial concepts. Driving best in class reserving across the enterprise for Medicaid and CHIP populations throughout Florida. This management position will focus on protecting the health of the Company's balance sheet by pushing the reserving frontier with companywide, actionable insights and spearheading the identification of risk areas using a forward-looking mindset.

Essential Duties and Responsibilities:

1. Develop strategies around comprehensive monitoring to efficiently highlight emerging trends.
2. Deliver extensive analytical review of various actuarial analyses such as IBNR, trend, rating actions, and valuation work in support of departmental objectives. Support junior team members, working with other areas within the Company, producing presentations for senior management and communicating status of deliverables to the department management.
3. Improve month-end financial and accounting processes for relevant actuarial estimates.
4. Lead continuous evaluation of total medical expense and cohort performance compared to plan expectations.
5. Lead cross-business unit and cross-functional projects that significantly impact the Company’s decisions around reserve levels.
6. Coordinate with finance team projections that are refreshed monthly and provided quarterly for forecasting and planning.
7. Value based care contracting support and ongoing financial and risk analysis.
8. Actuarial support for outside auditor review of financial estimates and results.
9. Design studies to monitor suitability of the completion factor estimates.
10. Lead continuous evaluation of risk-based funding and scoring performance compared to plan expectations.
11. Analyze and develop new to market assessments and modeling including future expansion and enhancements / changes to other market segments.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Work Schedule:

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule. Staff are able to work from home 3 days a week and will report to the office 2 days a week. *****The company reserves the right to change the work schedules based on the company needs.

Skills and Abilities:

• Comprehensive knowledge of actuarial principles, including risk assessment, pricing, reserving, and financial forecasting specific to health insurance products.
• Understanding of healthcare regulations, reimbursement methodologies, and industry trends affecting health insurance, including healthcare reform and emerging technologies.
• Strong organizational and project management skills to effectively prioritize tasks, meet deadlines, and coordinate cross-functional teams in delivering actuarial projects and reports.
• Ability to assess and manage risks inherent in health insurance products, including experience with risk mitigation strategies and decision-making under uncertainty.
• Strong written and verbal communication skills to effectively convey complex actuarial concepts to non-technical stakeholders, including senior management, regulators, and business partners.
• Ability to identify challenges and develop creative solutions to complex actuarial problems, including experience in scenario analysis and sensitivity testing.
• Commitment to staying abreast of industry developments, regulatory changes, and advancements in actuarial methodologies through ongoing professional development and participation in relevant seminars or conferences.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee may occasionally be required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

Qualifications:

• Bachelor’s Degree
• Fellow or Associate of the Society of Actuaries (FSA/ASA) designation required.
• Minimum of 6 years of experience in the healthcare industry.
• Advanced decision making and problem-solving skills
• Exceptional team building and employee development skills
• Track record of forming trusted relationships with business leaders
• Demonstrated experience providing proactive guidance to drive business value
• Excellent written and verbal communication skills; ability to tailor messaging to diverse audiences

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