Director, Actuarial Services

  • 36955
  • Health - Actuarial
  • |
  • Virginia, United States
  • |
  • Mar 9, 2020
Insurance
RESPONSIBILITIES
  • Will take a leading role in assisting company’s provider clients with contract negotiations, financial projections, and analyses aimed at improving performance.
  • Will involve supporting client strategic decision making as well as monitoring ongoing operations.
  • Will work with junior actuaries to forecast performance, generate actionable insights, and identify key result drivers.
  • Interacting and coaching teams of actuaries and non-actuaries.
  • Leading actuarial analysis and services in support of claims analysis, financial projections and pricing/product strategy.
  • Balancing growth and profitability goals to maximum results.
  • Assisting with and participating in negotiations and presentations where appropriate.
  • Evaluating provider organizations’ risk and compensation structure through the forecasting of financial/statistical data in a manner which is actuarially sound and competitive in the marketplace.
  • Incorporating organizational expectations for the financial impacts of clinical integration, population management processes provider contracts and benefit structures into rates and financial projections.
  • Evaluation of capitation rates, gain sharing programs and other contractual arrangements.
  • Managing unpaid claims reserves and forecasting future medical and pharmacy expense trends.
  • Presenting reports and analyses to clients and internal executives.
QUALIFICATIONS
  • B.S. in Actuarial Science, Math, Economics or related degree.
  • ASA required, FSA designation preferred.
  • 5+ years of experience in a health actuarial setting.
  • Direct or indirect leadership experience.
  • Strong verbal and written skills are required.
  • Strong technical skills required in Microsoft office.
  • Preferred:
  • The ideal candidate will have Medicaid experience working for an MCO, a state regulator, or a consulting firm.
  • Excellent communication and presentation skills. Must be comfortable presenting complex analyses to internal and external client executives.
  • Collaborative working style with the ability to work across different organizations and personalities.
  • Ability to multitask, prioritize, adapt to change, work well under pressure in an entrepreneurial environment, and manage a project from start to finish.
  • Familiarity with supporting Provider Organizations unique needs.