Manager of Actuarial Services

  • 33185
  • Life - Actuarial
  • |
  • Pennsylvania, United States
  • |
  • Oct 31, 2017
Insurance Organization
RESPONSIBILITIES
  • Use MA industry knowledge and expertise to provide strategic insights to management in making decision related to the MA line of business.
  • Participate as internal MA actuarial expert point of contact between external consultants and internal actuarial management. Must be qualified to be signing actuary for MA bids if necessary.
  • Play a key role in rebuilding, developing and managing part of the Actuarial department, with a primary focus on establishing actuarial expertise and process for the MA business.
  • Participate in the design and execution of actuarial department plans to bring actuarial functions in-house from external actuaries, and help select actuarial talent to build the department.
  • Play internal actuarial and MA expert role in supporting all state and federal regulatory reporting and filing requirements.
  • Work with multiple plan departments to represent actuarial perspective in identifying, implementing and coordinating improved information flow and tools to assure actuarial department’s ability to provide timely and accurate business intelligence.
  • Support monthly and other periodic financial statements and reporting to ownership and regulatory authorities as needed.
  • Develop productive, collaborative relationships with and act as liaison to other plan departments to drive a holistic, strategic approach to any business issues that impact or are affected by the actuarial functions. Such departments would include Finance, Medical Management, Medicare Sales & Operations, Claims, Information Services,
  • Health Care Economics, Compliance and Legal.
  • Provide MA analyses and recommendations to Actuarial and other areas that may affect Actuarial internal processes and operations as well as broader business financial, strategic and other business decisions.
  • Act as internal actuarial lead and play subject matter expert role on all aspects of MA bid development, including bid strategy, benefit strategy and design, bid compliance and manage external and internal actuarial resources and relationships involved with those functions.
  • Play a key role in designing, executing and managing actuarial analyses in both traditional actuarial functions such as reserving, forecasting, pricing, risk score analytics, and pricing; as well as ad hoc analyses needed to provide business intelligence to internal constituents.
  • Management responsibilities include managing and assigning workflow to actuarial direct reports and other staff in the execution of assigned actuarial responsibilities, and assuring alignment of actuarial priorities and work product with business needs as defined by Actuarial management.
  • Play a key role in the selection and hiring of actuarial staff, and managing actuarial and other staff on a project basis for both actuarial and inter-departmental projects. Manage continual improvement of actuarial processes and make changes as needed to support the business.
  • Manage, maintain and improve CMS risk score analyses, tools, reporting and forecasting as needed in the course of actuarial work.
  • Represent actuarial department and work products as needed to support internal and external compliance and other audit exercises involving Actuarial.
  • Represent Actuarial Services at meetings with other company departments as needed.
QUALIFICATIONS
  • Member of the American Academy of Actuaries and/or Associate or Fellow of the Society of Actuaries.
  • Experience must include a minimum of 7 years’ experience in the health insurance industry, with significant concentration on managed care.
  • 3+ years of recent, combined hands-on experience and managerial responsibility for substantial portions of MA and Part D bids and process, as well as other traditional actuarial functions
  • BS/BA required. Actuarial Science, Mathematics or other analytical curriculum is a plus.