Senior Healthcare Actuary

This position is a hybrid location. It is remote from home, besides quarterly in-person meetings in our Seattle office.

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work.

• Reduce health disparities.

• Create an equitable work environment.

About the Role

The Senior Healthcare Actuary will be responsible for developing and monitoring risk and rating assumptions and will lead required state and federal documentation pertaining to actuarial assumptions used in pricing of the products. The Senior Healthcare Actuary will provide management with analyses, reporting and recommendations on product performance. Other responsibilities include calculation/review of reserves and forecasting/trend analysis.

To be successful in this role, you:

• Have a Bachelors degree in Actuarial Science, Statistics or Mathematics.

• Have a current Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) credential.

• Have a minimum of eight (8) years working as Healthcare Actuary preferably at or on behalf of a health plan in managed Medicaid and/or Medicare Advantage and/or Individual & Family lines of business.

• Have experience in all aspects of health care actuarial practice including pricing, reserving, and forecasting.

• Have a current driver’s license, an acceptable driving record, and proof of automobile insurance for travel on behalf of CHPW.

Essential functions and

Roles and Responsibilities:

• Responsible for interpreting state and federal requirements related to product design, rate development, and premium stabilization programs.

• Completes actuarial modeling including development of lag triangles, completion factors, trends and reserve requirements.

• Manages federal actuarial filings.

• Manages state actuarial pricing submissions and review of proposed rating assumptions.

• Designs and builds complex data models.

• Performs quantitative analysis of actuarial, financial, utilization and cost data.

• Responsible for reviewing work of outside actuarial consultants to ensure accuracy and compliance with state and federal requirements.

• Manage projects from inception to completion.

• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

• Knowledge of recent healthcare related legislation

• Project management skills.

• Data analysis skills, including skilled in analysis of large data sets.

• Skilled in using Microsoft Office programs. Including Microsoft Excel spreadsheets and database applications.

• Communication skills including oral presentations and written reports.

• Ability to develop strong working relationships with state, federal, and consulting actuaries.

• Ability to prepare health plan statistical, financial, budgetary, and other specialty reports.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History

Includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.

• Vaccination requirement (CHPW offers a process for medical or religious exemptions)

• Candidates whose disabilities make they unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits

The position is FLSA Exempt and has a 10% annual incentive target based on company, department, and individual performance…