Job Description

Job Description

Job Description

Position Summary:

Community Care Plan is seeking an Actuary leader to join our strategic finance team. This fast-paced role provides an outstanding opportunity to influence data-driven business decisions. You will have exposure to all facets of the business and play 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.

The Senior Actuarial Analyst is 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. The person in this role will also develop presentations that provide information for decision making, understand business and actuarial concepts, and drive best in class reserving across the enterprise for Medicaid and CHIP populations throughout Florida. This position will focus on protecting the health of the Company's balance sheet by pushing the reserving frontier with companywide and actionable insights, and spearheading the identification of risk areas using a forward-looking mindset.

Essential Duties and Responsibilities:

• Perform comprehensive monitoring and analysis to identify emerging cost and utilization trends.
• Conduct actuarial analyses such as IBNR estimation, trend analysis, rating support, and reserve valuations.
• Collaborate with finance and operational teams to improve month-end financial processes related to actuarial estimates.
• Evaluate medical expense performance compared to plan expectations, including cohort-level insights.
• Support cross-functional efforts by providing actuarial insights to aid decisions on reserves, risk, and forecasting.
• Assist in monthly and quarterly forecast modeling in coordination with the finance team.
• Provide actuarial support for value-based care arrangements through financial modeling and risk analysis.
• Participate in audit-related actuarial work including data requests and reconciliation efforts for external auditors.
• Contribute to studies and reports that evaluate completion factors and reserve adequacy.
• Analyze data and provide insight into risk-based funding and scoring metrics.
• Support modeling efforts for new and expanding 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.

Qualifications:

• Bachelor’s Degree in Actuarial Science, Mathematics, Statistics, or a related field.
• Associate or Fellow designation in the Society of Actuaries (ASA or FSA) preferred.
• Minimum of 4–6 years of relevant actuarial experience in the healthcare industry.
• Strong decision-making and problem-solving skills.
• Ability to communicate complex actuarial concepts clearly.
• Proven ability to collaborate effectively with cross-functional teams.

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.

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