Job Description

Job Description

Job Description

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 them 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 goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s job-related knowledge, skills, and experience among other factors.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

• Medical, Prescription, Dental, and Vision
• Telehealth app
• Flexible Spending Accounts, Health Savings Accounts
• Basic Life AD&D, Short and Long-Term Disability
• Voluntary Life, Critical Care, and Long-Term Care Insurance
• 401(k) Retirement and generous employer match
• Employee Assistance Program and Mental Fitness app
• Financial Coaching, Identity Theft Protection
• Time off including PTO accrual starting at 17 days per year.
• 40 hours Community Service volunteer time
• 10 standard holidays, 2 floating holidays
• Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory* :

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical* :

• Extended periods of sitting, computer use, talking and possibly standing
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
• Frequent torso/back static position; occasional stooping, bending, and twisting.
• Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental :

• Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

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