Director, Actuarial Services

Madison•Madison, WI

2d•$150,000 - $257,200•Hybrid

About The Position

Medica is a nonprofit health plan serving more than a million members in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Director, Actuarial Services role leads actuarial work that analyzes financial experience, quantifies financial risk, and projects future medical expenses. The actuarial department aims to serve as Medica’s source of truth for product financial performance and medical trend by producing complete, timely, and accurate analysis. Senior actuarial leaders work with business segments to support their strategic goals and objectives while upholding professional and ethical standards established internally and by the American Academy of Actuaries. The position oversees experience studies, risk analysis, financial context and forecasting, product pricing, rate filings, compliance, and monthly actuarial results. It reviews actuarial work, guides analysts and consultants, and collaborates with segment and corporate leadership. This is an office role requiring onsite work an average of three days per week. Candidates may be located near the Minnetonka, Minnesota, or Madison, Wisconsin, office. Medica does not offer work visa sponsorship; candidates must be legally authorized to work in the United States at the time of application.

Requirements

Bachelor’s degree or equivalent experience in a related field.
10 years of experience.
5 years of leadership experience.
Fellowship in the Society of Actuaries (FSA), or ASA with demonstrated performance over multiple years under the supervision of a qualified actuary.
Member of the American Academy of Actuaries (MAAA).
Health actuarial or other related actuarial experience.
Legally authorized to work in the United States at the time of application; work visa sponsorship is not offered.

Nice To Haves

Commercial health insurance experience, including fully insured and self-insured business.
Experience with the Affordable Care Act (ACA).
Experience with rate and premium setting.

Responsibilities

Oversee the creation, development, and consistent production of accurate and timely actuarial information, reports, and exhibits.
Review analysts’ and other credentialed actuaries’ work for reasonability, appropriateness, and relevance.
Work with segment leadership on product design, particularly risk selection and induced utilization.
Direct analysts and/or consultants in identifying key variables for sensitivity testing.
Communicate key variances in actual versus expected financial performance to Medica and segment leadership.
Incorporate risk adjustment into financial projections and performance analysis.
Work with Medica and segment leadership to create appropriate financial targets for pricing and product performance.
Use appropriate benchmarks when analyzing utilization and provider data.
Provide appropriate actual-versus-expected analysis, including intra-year targets for Medica leadership, segments, and corporate finance.
Own the actuarial component of product pricing and work with segment leadership to incorporate actuarial, risk, and competitive information while aligning corporate and segment priorities around profit and growth.
Ensure forecast trend, revenue, and membership projections are used appropriately by segment and corporate finance.
Ensure rate filings and bids are accurate, timely, and consistent with segment strategies and goals.
Attend state negotiations and plenaries as necessary, and oversee preparation for rate negotiations, including rate-cell and geographic analysis.
Review actuarial work before publication, including low- and medium-risk work.
Sign rate-filing certifications and other actuarial communications after appropriate review.
Ensure timely and accurate monthly production of actuarial results for the segment or corporate reporting, as appropriate.
Participate in segment activities as directed by the General Manager, potentially including department meetings, recurring one-to-one meetings, and status reports to segment leadership.
Perform other duties as assigned.