Actuary - VBC/Provider Contracting (Remote)

CareFirst BlueCross BlueShield; Baltimore (MD); Remote; USD 172,000 - 318,000; Full time

Job summary

CareFirst BlueCross BlueShield seeks an experienced actuarial leader to guide pricing, underwriting, and analytics in health care. You will provide actuarial leadership to multiple business units and develop advanced models to support financial objectives.

You will direct staff, shape long-term actuarial strategy, and communicate complex results to executives and regulators while fostering a high-performing, compliant team.

Qualifications

• Bachelor's degree in Actuarial Science, Finance, Mathematics or related field, or an additional 4 years of relevant work experience.
• Fellow of the Society of Actuaries (FSA) required on hire.
• 8 years pricing/actuarial experience in health care; 3 years management experience.
• SOA exam progression/success is expected.

Responsibilities

• Direct actuarial staff across pricing, actuarial finance, Medicare Advantage, and innovation.
• Collaborate with senior management to set long-term strategy for Actuarial.
• Represent Actuarial to internal/external customers including regulators.
• Hire, recruit, and develop a growing, capable team.

Skills

Risk evaluation

Health insurance

Analytical skills

Communication skills

Leadership

Mainframe skills

Negotiation

Education

Bachelor's degree in Actuarial Science

Job description

Resp & Qualifications

Purpose

Performs advanced actuarial and oversight skills in the performance of actuarial analytics to develop actionable items in support of departmental goals Provides actuarial leadership support to Medical, Pricing, Underwriting, Sales, Finance and other applicable Business Units. Responsible for actuarial modeling to support financial objectives. and making recommendations to executives and senior management.

Essential Functions

• Responsible for directing the efforts of Actuarial staff (Pricing, Actuarial Finance, Actuarial Medicare Advantage, Actuarial Innovation and Research) to accomplish near and long term goals set by senior management.
• In collaboration with senior management, responsible for setting long term strategy within the Actuarial department.
• Responsible for representing the Actuarial department to internal and external customers including state and federal regulators.
• Hiring, recruiting and developing a purpose-driven, growing team with balanced, optimal work distribution, visibility and SOA exam success.

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.

Licenses/Certifications Upon Hire Required

• Fellow of the Society of Actuaries (FSA).

Experience

• 8 years progressively responsible pricing and actuarial experience in health care.
• 3 years management experience.

Knowledge, Skills And Abilities (KSAs)

• Extremely knowledgeable of risk evaluation and rating techniques and thoroughly familiar with a variety of health insurance products including HMO?s, Indemnity, POS/Opt-Out, Consumer-Driven and other products.
• Possesses highly developed analytical skills and excellent interpersonal and communication skills, both written and oral, to the point where complex actuarial and underwriting issues are effectively conveyed to a diverse audience.
• Must have computing skills with both PC-based and mainframe applications.
• Strong leadership skills, as well as the ability to effectively negotiate and sell company rating policy.
• 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

$171,520 - $318,384

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).

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