Mgr, Actuarial III

Horizon Blue Cross Blue Shield of New Jersey•Newark, NJ

About The Position

This is a senior level manager position within the Actuarial department. Performing analysis around the large employer commercial market to ensure long-term growth, profitability and compliance with state mandates & regulations. Requires partnership and cooperation with Sales, Underwriting and Finance to achieve organizational goals.

Requirements

Requires a Bachelor's degree, preferably within Mathematics, Statistics, Actuarial Sciences or a related field.
Requires 8+ years of Actuarial and/or statistics experience.
Requires the attainment of Associate level in the Society of Actuaries (ASA).
Requires expert knowledge of Excel.
Requires strong working knowledge of data analysis and Actuarial principles
Requires in depth knowledge of the healthcare industry.
Requires excellent oral and written communication skills.
Requires strong analytical thinking.
Requires strong mathematical skill and statistical analysis abilities.
Requires good judgment and problem-solving skills.
Requires strong managerial skills.
Requires strong leadership skills.

Nice To Haves

Prefers at least 3 years supervisory experience.
Prefers working knowledge of Access or other database application.
Experience with SAS, Snowflake, SQL or other programming language a plus.
Prefers experience with UDS discount metrics
Prefers experience with Stepwise rating engine

Responsibilities

Monitor the financial performance of the large employer fully insured markets, including Midsize and Public
Lead actuarial studies to refresh rating methodology and factors and manage the implementation of updates within the Stepwise rating engine
Monitor and evaluate discount metrics for the large employer self-insured markets, identifying data quality issues and developing strategies to improve performance and accuracy
Conduct pricing studies for new state mandates or other non-standard underwriting requests
Oversee Mental Health Parity testing & compliance
Forecast and manage performance guarantees for self-insured employers including the State Health Benefit Plan