CareFirst BlueCross BlueShield

Actuary - VBC/Provider Contracting (Remote)

CareFirst BlueCross BlueShield$171K — $318K *
US-AnywhereRemote in Baltimore, MD
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Actuarial Science, Finance, Mathematics, or related field, or 4 additional years of relevant experience in lieu of a degree.
  • Fellow of the Society of Actuaries (FSA) certification required.
  • 8 years of progressively responsible pricing and actuarial experience in healthcare.
  • 3 years of management experience supervising actuarial teams.
  • In-depth knowledge of risk evaluation and various health insurance products.

Responsibilities

  • Direct the actuarial staff to achieve departmental goals set by senior management.
  • Set long-term strategy for the Actuarial department in collaboration with senior management.
  • Represent the Actuarial department to internal and external stakeholders, including regulators.
  • Hire, recruit, and develop a high-performing actuarial team with balanced workloads.
  • Support actuarial modeling that aligns with financial objectives and provide insights to executives.

Benefits

  • Comprehensive benefits package including health and wellness programs.
  • Various incentive programs and performance-based plans.
  • 401k contribution programs.
  • Professional development opportunities and support for SOA exam success.
Full 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).

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

#LI-CB1

About CareFirst BlueCross BlueShield

CareFirst BlueCross BlueShield is a regional health insurance company that serves over 3.4 million members in Maryland, the District of Columbia, and Northern Virginia. It is a nonprofit organization and the largest health insurer in the Mid-Atlantic region. The company offers a variety of health insurance plans, including individual and family plans, Medicare plans, and employer-sponsored plans.
Learn more about CareFirst BlueCross BlueShield
Size
5,000 employees
Industry

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