Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.Salary range for position: $160,724 - 198,542*Individual starting salary within this range may depend on geography, experience, expertise, and education/training.*Position SummaryThis position provides a wide range of actuarial expertise and support to the company, including responsibility for the actuarial support of Medicare product bids, US Family Health Plan (USFHP) rate negotiations with the Department of Health Administration (DHA) representation with external actuaries and others, planning and performance monitoring, expertise, consultation, analysis and reporting surrounding medical expense. As a largely individual contributor, this position must function well in a matrix management environment.Job DescriptionKey Outcomes:Support the annual Medicare Advantage and Prescription Drug (MA/PD) bid development by working with the business and consulting actuarial firm on product design, trend review, and supplemental benefit projections that align with corporate objectives for growth and profit margin.Has lead responsibility for preparation and presentation of annual business healthcare expense budget and forecasting.Designs and implements measurement and monitoring of key performance metrics to identify trends and variances from budget and enable corrective actions on a timely basis.Provide analysis and advice to support the US Family Health Plan (USFHP) annual rate negotiation. Lead analysis and calculation of incurred but not reported claims (IBNR).Prepare and analyze monthly estimates for Medicare Part D settlement estimates.Develop and maintain knowledge and expertise in regional and national managed health care trends and best practices, seeking opportunities to translate those to Martin’s Point.Manage the process for annual medical cost and utilization projections and forecasts, by coordinating resources, expertise and information in concert with the financial planning cycle.Provide expertise and consultation on a wide array of business functions including, but not limited to provider reimbursement, claims processing, benefit adjudication, and complianceSupport senior management (Chiefs and VPs) with special projects and research, including compiling white papers on special topics, as needed.Collaborates with the business to ensure appropriate integration of workstreams and ultimate delivery on company strategies.Communicates and interacts effectively and professionally with co-workers, management, Website degree in actuarial science, math, statistics or a related field is required.8+ years of progressive actuarial experience in a wide range of medical expense analyses, contracting in a managed care setting, preferably in commercial and government programs business.Experience developing and managing a wide array of financial arrangements is preferred.Required License(s) and/or Certification(s):Associate of the Society of Actuaries and Member of the American Academy of Website (Behaviors):Demonstrates an understanding of and alignment with Martin’s Point Values.Strong analytical skills.Demonstrated interpersonal, communications and team building skills.Strategic ability to see the big picture and connect dots across mathematical and financial relationships and across an organization.Proven ability to organize work, simultaneously work on many activities and projects and meet deadlines directly and through matrix management.Strong track record of building internal and external collaborative relationships.Broad understanding of managed care business and financial principals such as underwriting, medical management, physician reimbursement and risk management.Strong oral and written communication to support executive level briefings and presentations both internal and external to Martin’s Point.This position is not eligible for immigration sponsorship.We are an equal opportunity/affirmative action employer. #J-18808-Ljbffr