At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com
Location: Hybrid (3 days in-office, 2 remote) | 3875 West Chester Pike, Newtown Square, PA 19073
Key Responsibilities:
- Lead valuation and reserving for Medicaid, Medicare, and Marketplace Exchange, managing IBNR calculations, PDR (Premium Deficiency Reserves), and reserve adequacy assessments.
- Oversee financial and statutory reporting, including actuarial opinions, GAAP/Statutory filings, and risk adjustment methodologies to ensure compliance with NAIC and CMS regulations.
- Develop and implement actuarial models for reserving, financial forecasting, and trend analysis, ensuring alignment with business and financial objectives.
- Drive operational improvements in actuarial shared services, leading automation, process efficiency, and cross-functional collaboration.
- Provide executive-level insights to senior leadership, shaping financial strategy and risk management.
- Mentor and manage actuarial teams, ensuring analytical excellence and compliance.
- Partner with finance, IT, and regulatory bodies to enhance data integrity and strategic alignment.
Education & Experience:
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field.
- FSA (Fellow of the Society of Actuaries) or ASA (Associate of the Society of Actuaries).
- Technical proficiency in AXIS, Prophet, SAS, R, Python, SQL, and Excel.
- VP-level leadership is required with a proven track record in health valuation, reserving, and statutory reporting.
- Minimum of 5-10 years of actuarial experience with specifics to Medicaid, Medicare, and Marketplace Exchange.
- Expertise in regulatory compliance, financial modeling, and actuarial opinion development.
- Strong executive presence, with the ability to present complex actuarial concepts to senior leadership and external stakeholders.
- Strategic thinking and problem-solving skills, with the ability to drive innovation in valuation, forecasting, and shared services.
- Excellent communication and interpersonal skills, fostering collaboration across teams and regulatory partners.
- Ability to mentor and develop actuarial talent, build high-performing teams, and cultivate leadership growth.
- Adaptability and resilience in a fast-paced, evolving regulatory and business environment.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.