Senior Manager, Actuarial - Risk Adjustment

Overview

This role supports the Actuarial team’s work on the ACA risk adjustment program by analyzing financial implications and driving reporting, forecasting, and related risk adjustment analyses.

Responsibilities

• Develop capabilities to predict risk scores and ACA market morbidity, partnering with cross-functional teams of actuaries and data scientists.
• Source new data and use creative approaches to improve Oscar and market-level predictions.
• Maintain and evolve core risk adjustment reporting and forecast models.
• Conduct research to enhance risk adjustment knowledge and capabilities, including views of the company’s membership and other carriers in the market.
• Contribute to estimated risk adjustment transfer estimates for monthly closes and ongoing financial forecasts.
• Perform risk adjustment analyses, including analyzing drivers of risk adjustment performance.
• Lead quarterly audit deliverables and maintain internal control compliance to support accurate financial reporting.
• Promote and shape actuarial best practices related to automation and documentation.
• Maintain strong relationships and communications with internal and external stakeholders.
• Support analyst onboarding by collaborating and integrating new analysts into existing processes.
• Ensure compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• College degree or commensurate skills attainment.
• Associate or Fellow of the Society of Actuaries (SOA).
• 6+ years of quantitative analysis experience.

Preferred Qualifications

• Strongly prefer ACA Risk Adjustment, ACA Pricing/MedEcon, or Non-ACA Risk Adjustment expertise.
• Strong understanding of health insurance concepts and nuances.

Compensation & Benefits

• Base pay (states of California, Connecticut, New Jersey, New York, and Washington): $163,944 - $215,177 per year.
• Base pay (all other locations): $147,550 - $193,659 per year.
• Eligible for employee benefits.
• Participation in an unlimited vacation program.
• Annual performance bonuses.
• Final offer amounts within the base pay set forth above are determined by factors including relevant skills, education, and experience.
• Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Location

• Fully remote.
• Open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories.
• Daily work is completed from the home office; occasional travel may be required for team meetings and company events.