Actuarial Director - Government Programs

Blue Cross Blue Shield of Minnesota•Eagan, MN

5d•Hybrid

About The Position

Blue Cross and Blue Shield of Minnesota is seeking a strategic actuarial leader to oversee its Medicaid and Medicare Cost/Supplement teams. This role is accountable for the product lifecycles of these products —including DHS Medicaid managed care rate negotiations, pricing, rate filing, forecasting, and financial analyses. The Director will provide leadership, guidance, and motivation to the actuarial team while partnering closely with cross‑functional areas such as product, legal, marketing, finance, regulatory affairs, data and analytics, enterprise risk adjustment, and provider networks. Success in this position requires strong executive presence, proven people leadership, and the ability to adapt to the fast‑paced and evolving health insurance landscape. Ideal candidates have deep Medicaid Managed Care expertise, more than five years of people‑leadership experience, strong actuarial judgment, and a blend of technical proficiency and strategic leadership orientation.

Requirements

Accepting this position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment.
10+ years of experience in the areas of actuarial, finance or related field, including experience in managed care.
All relevant experience including work, education, transferable skills, and military experience will be considered.
5+ years of staff, team lead and/or project lead experience.
2+ years in-depth experience with market segment products (Medicaid, Medicare Cost, Medicare Supplement).
FSA or ASA designation.
MAAA designation.
Experience working with cross-functional teams and juggling multiple client priorities in a fast-paced environment.
Demonstrated delegation and management skills.
Demonstrated ability to influence executive level leaders with in-depth data and analysis.
Outstanding oral and written communication skills, including ability to story tell and articulate financial analysis to non-financial colleagues.
High school diploma (or equivalency) and legal authorization to work in the U.S.

Nice To Haves

Bachelor's or Master's /MBA degree in mathematics, statistics, actuarial science, economics, finance, accounting or related field.
Significant Healthcare industry or health insurance industry experience
Proven experience in both actuarial strategy and hands‑on modeling, with deep expertise in Medicare Part C and Part D; including bid development, forecasting, and the ability to translate complex model outputs into clear strategic recommendations.
Demonstrated ability to stand up regulatory changes, lead forecasting and model updates, and manage a high‑performing actuarial team.
Experience implementing regulatory changes and assessing related financial, operational, and strategic impacts.
Advanced actuarial modeling and forecasting expertise, including familiarity with modern or cloud‑based modeling tools and environments.

Responsibilities

Serve as the actuarial line of business owner for specified market segment products (Medicaid, Medicare Cost, Medicare Supplement).
Manage a team responsible for all actuarial activities including budgeting, forecasting, trend analysis and revenue/cost driver identification and evaluation.
Communicate with executive leadership in an effective and straightforward manner, serving as a thought leader in the management of financial risk and a role model of strategic, proactive communication and collaboration across teams.
Partner with DHS and their contracted actuaries to influence rate adequacy, assess financial implications of proposed methodologies, and advocate for accurate reflection of risk, trends, and program changes to ensure sustainable and compliant Medicaid reimbursement.
Collaborate with underwriting, product, marketing and sales by making recommendations for amending or developing products, product pricing and processes to maintain product viability and financial soundness while delivering strategic growth and managing risk.
Serve as an advocate for innovation.
Oversee Managers who serve as the primary contacts with State and Federal regulators for rate and annual filings ensuring timeliness, acceptance by regulators and appropriate loss ratios for regulatory and corporate requirements for solvency, profitability and compliance.
Stay abreast of regulatory changes, ensuring all responsibilities are addressed, as well as providing thought leadership on how best to adjust strategy in light of regulatory changes.
Adeptly navigate communication of complex actuarial and/or accounting concepts to non-technical audiences, ensuring enterprise leadership is informed of current and forecasted business results and underlying risks.
Maintain a strong understanding of how actuarial judgment applied in valuation processes drives the enterprise’s narrative of results and actively balance the need for conservatism with timely messaging of departures from expected results.
Provide insightful research, analysis and interpretation of actuarial and statistical data, providing strategic insights to drive decision making within the department, with other teams and Executive business leaders across the enterprise.
Develop new tools, based on predictive modeling and machine learning, to refine and modernize current actuarial models and methods.
Lead team in transformation into cloud-based data configuration.
Leads comprehensive performance evaluations and actively manages employees by fostering skill and career development, administering policies, and providing targeted coaching on both performance and professional behavior.
Oversee hiring and onboarding processes to build a high-performing team.
Champions thorough documentation of procedures, peer review and best practices to ensure process consistency and improvement.
Builds a positive employee relations environment and implements effective cost control measures to support organizational goals.
Personally model BCBSMN’s enterprise values and serve as a role model of strong people leadership skills both within and outside of the Actuarial department.