Full-Time

Manager – Actuarial Services

Posted on 2/26/2025

Healthfirst

Healthfirst

1,001-5,000 employees

Compensation Overview

$100.9k - $145.8k/yr

Senior

Company Does Not Provide H1B Sponsorship

New York, NY, USA

Hiring range is for Greater New York City Area (NY, NJ, CT residents).

Category
Insurance
Finance & Banking
Required Skills
Python
SAS
SQL
Data Analysis
Requirements
  • Bachelor’s degree in actuarial science, Math, Economics, Finance or any related degree
  • Experience in the actuarial field related to Medical Trend
  • Experience working with medical claims codes and datasets
  • Experience with programming/coding, preferably SAS, SQL, or Python
  • Ability to collect, analyze and summarize qualitative/quantitative data
Responsibilities
  • Build and maintain models for analyzing historical medical trend which normalize for impacts of seasonality, fee schedules, benefits, population changes, etc.
  • Monitor and interpret drivers of medical trend separating unit cost, utilization, mix, severity, etc.
  • Track and assess industry trend resources, where applicable.
  • Partner with other teams to align on emerging trends and insights.
  • Develop projection trend assumptions/factors, including model and method development, to support other actuarial functions such as reserving, forecasting, and pricing.
  • Participate in monthly close meetings, Quarterly Business Reviews, and Annual Budget on topics related to explaining medical trend experience, drivers, assumptions, and projections.
  • Manage and direct staff as appropriate.
Desired Qualifications
  • ASA (Associate, Society of Actuaries) membership
  • MAAA (Member, American Academy of Actuaries) membership
  • Prior work experience managing one or more staff

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

New York City, New York

Founded

1993

Simplify Jobs

Simplify's Take

What believers are saying

  • Partnerships with tech firms like Hyphen boost innovative care solutions.
  • Healthfirst's health equity programs address disparities effectively.
  • Community health initiatives expand access to care in underserved regions.

What critics are saying

  • Competition from companies like Twilio offering integrated data solutions.
  • Pharmacy Incentive Program's reliance on community pharmacists poses operational challenges.
  • Dependence on partnerships for legal assistance may face disruptions.

What makes Healthfirst unique

  • Healthfirst collaborates with Hyphen to enhance value-based care through pharmacy programs.
  • The company focuses on health equity with initiatives like Healthfirst ADVANCE.
  • Healthfirst's community-based programs improve access to care in underserved areas.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) Company Match

Performance Bonus

Company News

Business Wire
May 15th, 2024
Hyphen, Healthfirst Collaboration To Empower Pharmacists’ Role In Value-Based Care Receives 2024 Points Of Light Award From Klas Research

HARTFORD, Conn.--(BUSINESS WIRE)--Hyphen, the technology company creating connected-care, has received a 2024 Points of Light Award from KLAS Research, the leading healthcare research and insights firm, for its efforts to improve payer-provider collaboration in support of improved outcomes in value-based care with Healthfirst, a non-profit health plan serving close to 2 million New Yorkers. KLAS recognized Hyphen’s Pharmacy Assistant application, which supports Healthfirst’s Pharmacy Incentive Program. The program is designed to empower community pharmacists within Healthfirst’s network to take action to improve medication adherence rates, increase members’ understanding of their health plan benefits, and get compensated for those actions. This program is especially impactful because 80% of Medicare Advantage members in New York visit their community pharmacy 5-10 times annually — more than they visit their primary care doctor. The Pharmacy Assistant application connects disparate data sources and delivers real-time, actionable information in pharmacists’ existing workflows so they can close care gaps

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WNewsJ
Sep 20th, 2023
Health First announces local grants

HealthFirst partnered with the Clinton County Foundation to ensure grant funding is annually available to the community.

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Aug 10th, 2023
Health First Pharmacy Careers in Dubai - Abu Dhabi and Al Ain

Health First Pharmacy Careers UAE: Health First Pharmacy has published the latest job vacancies on its Careers page.

Clinton County Ohio Foundation
Aug 8th, 2023
Health First Renews Focus on Individual and Community Health and Wellness

HealthFirst partnered with the Clinton County Foundation to ensure grant funding is annually available to the community.

INACTIVE