Actuarial Associate - Medicare Risk Adjustment (Remote)

CareFirst BlueCross BlueShield; Baltimore (MD); Remote; USD 102,000 - 211,000; Full time

Job summary

CareFirst BlueCross BlueShield seeks a Supervisory Actuarial Analyst to lead a team of analysts, implement departmental strategy, and report to Actuarial management. The role focuses on coordinating activities, providing training, and ensuring policy adherence.

Key responsibilities include developing and reviewing complex analyses (IBNR, trend, rating actions, valuation) and presenting findings to senior leadership while guiding junior staff and maintaining high-quality standards.

Qualifications

• Bachelor's degree in Actuarial Science, Finance, Mathematics or related field, or equivalent experience.
• ASA designation required.
• 3 years health actuarial experience with leadership.

Responsibilities

• Coordinate analysts' activities, provide training, monitor performance, and ensure policy adherence.
• Develop and analytically review actuarial analyses (IBNR, trend, rating actions, valuation) and present to senior management.
• Oversee calculations, serve as SME, direct workflow and ensure sound actuarial methods.

Skills

Organizational skills

Flexibility

Problem-solving

Communication skills

Negotiation

Analytical skills

Customer service

Education

Bachelor's degree in Actuarial Science, Finance, Mathematics or related field

ASA certification

Tools

None

Job description

Resp & Qualifications

PURPOSE: This position oversees and directs the work of analysts in a supervisory capacity. This position is responsible for implementing departmental strategy and policies in order to meet team goals, as well as making recommendations to Actuarial management where appropriate.

Essential Functions

• Responsible for coordinating the activities analysts ensuring accurate and timely release of requested analyses and reports. Responsible for providing training, development, documenting performance issues, if needed, and monitoring and enforcing adherence to Company policies. The Supervisor sets objectives, writes and deliveries performance feedback and appraisals, promotions, salary increases, hiring and disciplinary communications.
• Responsible for coordinating the development and extensive analytical review of various actuarial analyses such as IBNR, trend, rating actions, and valuation work in support of departmental objectives. This includes supporting the junior team members, working with other areas within the Company, producing presentations for senior management and communicating status of deliverables to the department management.
• Oversee calculations, serve as Subject Matter Expert (SME), direct the workflow and ensure that sound actuarial and financial methods are used by Analysts.

Supervisory Responsibility

This position manages people.

Qualifications

Education Level: Bachelor's Degree in Actuarial Science, Finance, Mathematics or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

• Associate of the Society of Actuaries (ASA)

Experience: 3 years health actuarial experience with demonstrated leadership.

Knowledge, Skills And Abilities (KSAs)

• Ability to organize to task completion, plan and prioritize work.
• Must demonstrate flexibility, innovation and problem-solving skills and resourcefulness.
• Ability to express technical and financial analysis in a clear, concise manner on both written and oral form.
• Must possess negotiating and consulting skills.
• Possesses highly developed analytical skills and excellent interpersonal and communication skills, both written and oral.
• Effectively convey actuarial and/or underwriting issues to a diverse audience.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $102,384 - $211,167

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Actuarial Member Analytics and

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

Physical Demands

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship