Director, Actuarial Services I

Overview

This Director, Actuarial Services position supervises staff in the routine operations of the Actuarial Services department. The role leads healthcare cost trend and medical cost analysis, and oversees financial forecasting and budgeting for the health plan. Responsibilities include developing actuarial and financial recommendations that support target pricing margins, organizational goals, new initiatives, and complex measures related to financial solvency. Work involves preparing and interpreting data, applying formulas, and partnering with internal teams, external vendors, and regulators using both national and local information sources.

Responsibilities

• Build new quarterly trend and forecasting processes in collaboration with Health Care Network Management.
• Develop quarterly health plan financial forecasts and required monthly analyses.
• Develop the health plan financial budget.
• Coordinate forecast and budget development across all lines of business.
• Develop dental reporting, small group pricing, and rate filings.
• Forecast health plan margin strategy requirements.
• Develop, trend, and maintain trend models.
• Conduct trend analysis to support pricing, forecasting, and opportunity identification.
• Perform Monthly Stop Loss reserve analysis and provide support.
• Develop seasonality analyses.
• Design, implement, and maintain medical expense trend models, including cross-functional collaboration and information sharing.
• Ensure efficient use of SAS software in developing data sets and models.
• Develop and maintain the appropriate level of SAS expertise within the department.
• Identify and manage departmental goals aligned with corporate objectives.
• Establish annual performance goals for staff; guide learning and development plans; assess performance; determine merit, promotional, and recognition salary increases and awards.
• Ensure efficient department management and promote continual process improvement.
• Mentor and develop staff to take on leadership roles.
• Ensure consistent policies and procedures across regions.
• Represent the department on special projects.
• Identify emerging issues that impact corporate, divisional, or departmental goals.
• Notify Information Management regarding Data Warehouse integrity issues.
• Prepare and maintain documentation for routine procedures and special projects.
• Support the organization’s mission, values, and adherence to the Corporate Code of Conduct and related “Lifetime Way” values and beliefs.
• Maintain member privacy in accordance with corporate privacy policies and procedures.
• Maintain knowledge of relevant legislative and regulatory mandates and ensure compliance.
• Conduct periodic staff meetings, including timely distribution and education related to departmental and Ethics/Compliance information.
• Maintain regular and reliable attendance.
• Perform other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics or related field
• Eight years actuarial experience in a healthcare environment
• 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

Preferred Qualifications

• Professional designations: Fellow of the Society of Actuaries and Member of the American Academy of Actuaries (MAAA)
• Minimum three years of experience in a leadership role (minimum five years preferred)

Level II (Additional Requirements)

• Minimum of ten years of actuarial experience

Physical Requirements

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Compensation & Benefits

• Level I: Grade D5: Minimum $137,857 - Maximum $248,143
• The posted salary range represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, and internal equity.
• The posted salary range reflects one component of a total rewards package. Other components may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Location / Remote Work

There may be opportunity for remote work within all jobs posted by the talent acquisition team. This decision is made on a case-by-case basis.