Director, Actuarial Services I

Excellus BCBS • De Witt, AR

1d • $137,857 - $248,143

About The Position

The Director, Actuarial Services supervises staff in the routine operation of the Actuarial Services departments and leads healthcare cost trend and medical cost analysis, as well as the health plan’s financial forecasting and budgeting. The Director develops actuarial and financial recommendations to protect the organization’s financial integrity and support target pricing margins, corporate goals, new initiatives, and other complex measures related to financial solvency. The role includes preparing and interpreting data and related formulae, using national and local information sources, and working with internal staff, external vendors, and regulators.

The Director is accountable for financial forecasting and budgeting across lines of business, trend analysis and model development, pricing and rate filings, and reserve analysis. The position also leads departmental goal-setting, staff development and performance management, process improvement, compliance, and representation of the department on special projects. Level II requires similar qualifications to Level I, plus at least ten years of actuarial experience.

Requirements

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.
• Eight years of actuarial experience in a healthcare environment; Level II requires at least ten years of actuarial experience.
• At least three years of experience in a leadership role.
• Advanced analytical skills.
• Advanced knowledge of financial and risk arrangements.
• Strong PC skills and proficiency in Microsoft Office.
• Strong verbal and written communication skills.
• Strong project and people management skills.
• Strong leadership skills.
• Ability to translate technical concepts into business language.
• Ability to design and implement process improvements.
• High integrity and interpersonal skills.
• High sense of urgency and accountability.
• High degree of independence, creativity, and initiative.

Nice To Haves

• Fellow of the Society of Actuaries designation.
• Member of the American Academy of Actuaries (MAAA).
• At least five years of experience in a leadership role.

Responsibilities

• Build a quarterly trend and forecasting process in collaboration with Health Care Network Management staff.
• Develop quarterly health plan financial forecasts and necessary monthly analyses.
• Develop the health plan financial budget and coordinate forecast and budget development for all lines of business.
• Develop dental reporting, small group pricing, and rate filings.
• Forecast health plan margin strategy requirements.
• Develop and maintain trend models and conduct trend analysis to support pricing, forecasting, and opportunity identification.
• Conduct monthly Stop Loss reserve analysis and support.
• Develop seasonality analyses.
• Design, implement, and maintain medical expense trend models through cross-functional collaboration and information sharing.
• Ensure efficient use of SAS software to develop data sets and models, and develop and maintain departmental SAS expertise.
• Identify and manage departmental goals consistent with corporate objectives.
• Establish staff performance goals and learning and development plans; assess performance and determine merit, promotional, and recognition increases and awards.
• Ensure efficient department management and promote continual process improvement.
• Mentor and develop staff for leadership roles.
• Ensure consistent policies and procedures across regions.
• Represent the department in a leadership role on special projects and identify emerging issues affecting corporate, divisional, or departmental goals.
• Notify Information Management of Data Warehouse integrity issues.
• Prepare and maintain documentation for routine procedures and special projects.
• Support the Lifetime Healthcare Companies’ mission and values, follow the Corporate Code of Conduct, and lead according to the Lifetime Way values and beliefs.
• Protect member privacy in accordance with corporate privacy policies and procedures.
• Maintain knowledge of applicable legislative and regulatory mandates and ensure activities comply with them.
• Conduct periodic staff meetings, including timely distribution of and education on departmental and Ethics/Compliance information.
• Maintain regular and reliable attendance and perform other functions assigned by management.

Benefits

• Group health and/or dental insurance may be included in the total rewards package.
• Retirement plan may be included in the total rewards package.
• Wellness program may be included in the total rewards package.
• Paid time away from work may be included in the total rewards package.
• Paid holidays may be included in the total rewards package.

What This Job Offers

• Job Type: Full-time
• Career Level: Director