Manager of Actuarial Services

About the role

Serves as key resource and leads actuarial services for VNS Health Plans product lines. Provides quantitative support to VNS Health Plans Finance Department and Actuarial Services team through a broad range of responsibilities including pricing, reserving, research, data analysis, financial reporting, documentation, and the development of a controlled actuarial environment. Works under general supervision.

Responsibilities

• Manages monthly IBNR development and other liability valuations.
• Reconciles claims data with the general ledger to identify and explain discrepancies.
• Automates and modernizes valuation models and processes.
• Communicates reserving recommendations and P&L impacts to senior management.
• Led key quantitative and qualitative analyses, including cost and utilization tracking, Medical Loss Ratio (MLR) reporting, reconciliations, and member cohort analyses.
• Serves as the actuarial project lead for all regulatory entities, including the Centers for Medicare & Medicaid Services (CMS), National Association of Insurance Commissioners (NAIC), Department of Health (DOH), rate reviewers, auditors, and other regulatory agencies.
• Oversees the collection and preparation of materials used in audit-related activities.
• Supports the annual Medicare bid process, including data collection and cleansing, trend development, and financial reconciliation.
• Maintains and modernizes a comprehensive Medical Loss Ratio (MLR) database to monitor and analyze member-level revenue, medical expenses, and administrative costs.
• Liaises with internal departments to establish and maintain strong lines of communication across all areas impacting actuarial functions.
• Performs all duties inherent in a managerial role, including ensuring effective staff training, interviewing candidates for employment, evaluating staff performance, conducting annual performance appraisals, and recommending hiring, promotions, salary actions, and terminations, as appropriate.
• Participates in special projects and performs other duties as assigned.

Qualifications

• Licenses and Certifications: Associate of the Society of Actuaries (ASA) designation preferred.
• Education: Bachelor's Degree in Mathematics, Actuarial Science, Statistics, Biostatistics, or related discipline required.
• Work Experience: Minimum of six years of progressively responsible actuarial experience in a Health Plan, Managed Care organization, or similar environment, including supervisory experience. Medicare and Medicaid experience preferred.
• Required Expert knowledge of Actuarial Standards of Practice (ASOPs), Centers for Medicare & Medicaid Services (CMS), National Association of Insurance Commissioners (NAIC), and core health actuarial processes, including valuation, financial reconciliation, and budgeting/forecasting.
• Required Experience composing and facilitating presentations.
• Required Demonstrated proficiency in manipulating and analyzing large, complex datasets from multiple sources using Snowflake and Python.
• Required Proficiency in Microsoft Excel.
• Required Ability to communicate quantitative analyses and results in a clear, concise, and actionable manner.

Pay

USD $109,900.00 - USD $146,500.00 /Yr.

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.