Actuary, Risk Adjustment

2 weeks ago


New York, New York, United States Oscar Health Full time
About the Role

Oscar Health is seeking an experienced Actuary, Risk Adjustment to join our Actuarial team. As a key member of our team, you will play a critical role in supporting our valuation, risk adjustment, forecasting, strategy, and pricing processes for several Affordable Care Act (ACA) markets.

You will be responsible for reviewing pricing, establishing Incurred but not Reported (IBNR) projections, risk adjustment accruals, and investigating actual performance trends to inform budget planning, pricing, and company strategies. You will also support the regulatory submission process, ensure pricing is actuarially sound, and collaborate with cross-functional teams to drive business growth.

This is an exciting opportunity to join a dynamic team and contribute to the success of Oscar Health. If you have a strong background in actuarial science, excellent analytical and communication skills, and a passion for risk management, we encourage you to apply.

Responsibilities
  • Develop and maintain risk adjustment projection models, forecasts, and trend analytics.
  • Contribute to the development and submission of regulatory filings, and provide actuarial viewpoints for strategic pricing decisions.
  • Collaborate with cross-functional teams to drive business growth and ensure actuarial soundness of pricing.
  • Support the regulatory submission process and ensure compliance with all applicable laws and regulations.
  • Other duties as assigned.
Requirements
  • College degree in a STEM field.
  • Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one.
  • 4+ years of quantitative analysis experience.
Preferred Qualifications
  • Excellent communication, collaboration, and relationship-building skills.
  • Strong understanding of health insurance concepts and nuances.
  • Experience in ACA or other line of business risk adjustment.


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