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Role Description

Manages and provides technical guidance to the staff responsible for conducting actuarial studies and activities. Directs staff and plays an active role in the preparation and interpretation of data and related formulae. Monitors level and trend of profit and profitability by line of business and/or product.

• Perform and analyze actuarial research, experience studies, statistical analyses, calculations, and audits.
• Supports and develops corporate information systems and understands relationship to Actuarial/Underwriting applications.
• Compile and verify data, prepare reports. Provide various levels of analysis and modeling work.
• Prepare schedules, document factors.
• Review data with external agencies, auditors, etc.
• Develop actuarial assumptions.
• Develop, calculate and analyze rates, reserves, provider contract terms, etc.
• Participate in establishment of departmental goals and plans.
• Attend or may lead company task forces or committees.
• Provide guidance and advice on rates.
• Monitor level of trend and profitability.
• Responsible for employment, training, performance management etc. Manages all aspects of unit, including meeting expected deadlines and keeping management informed.
• Oversee preparation of actuarial portions of financial statements.
• Monitor state/federal regulations to ensure compliance.
• Supervise and communicate analyses of sales, expense, and related factors for profitability reporting.

Qualifications

• Ability to take a primary role in project management, develop complex project work plans, prepare departmental activity plans and updates.
• Able to identify potential issues/problems for consideration at the management level.
• Demonstrated ability to lead projects and teams. Technical leader.
• Ability to work effectively in consulting role in dealing with peers and/or management team.
• Ability to respond effectively to the most sensitive inquiries or complaints.
• Ability to make effective and persuasive presentations on controversial or complex topics to associates, top management, or public groups.

Requirements

• Excellent technical knowledge of PC and network software, including Word, Excel, Access and PowerPoint.
• Working knowledge of advanced database query tools and their application.
• Thorough knowledge of company benefits, programs, medical model, regulatory and other environmental aspects.
• Five or more years of experience in a variety of HMO/healthcare environments required.

Education and Certifications

• Prefer a bachelor’s degree in mathematics, Statistics, Economics or Computer Science or equivalent experience in underwriting/actuarial functions.
• ASA & MAAA required.

Physical Demands

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must occasionally lift and/or move up to 5 pounds.

Benefits

• Comprehensive benefits package including Medical, Dental & Vision coverage.
• Retirement Plan.
• Generous time off including Paid Time Off, Holidays, and Volunteer time off.
• Incentive Plan.
• Tuition Reimbursement.

Company Description

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital, you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.