Sr. Director, Actuary, Corporate Actuarial

Your Role

 

The Corporate Actuarial team is responsible for Health Plan’s Incurred but Not Reported (IBNR) valuations, trendsetting and other actuarial projections. The Senior Director, Actuary, Corporate Actuarial will report to the Chief Actuary. In this position, you will be responsible and accountable for the results of actuarial functional areas related to reserving, trend setting, risk score forecasting, and ad-hoc analysis on healthcare cost initiatives.

Your Work

 

In this role, you will:

• Lead the valuation process for IBNR reserves, ensuring accuracy and compliance with regulatory requirements. Develop and maintain models to estimate IBNR liabilities and provide insights into reserve adequacy
• Present detailed actuarial reports and presentations to senior management, Board Audit Committee, auditors and regulatory bodies. Act as Appointed Valuation Actuary for California Department of Insurance products
• Lead team to analyze and interpret health care cost trends to support pricing and financial planning. Develop and communicate trend projection assumptions (known as Trendsetters) based on historical data and emerging market trends
• Draw insights from risk score emerging metrics to forecast for multiple lines of business and collaborate with Risk Adjustment operational teams
• Guide actuarial and medical informatic professionals to conduct ad-hoc actuarial analyses to support various business needs, including cost-benefit analyses, financial impact assessments, and strategic decision-making. Provide actionable insights and recommendations based on the analysis.
• Lead a team of actuaries and analysts, foster a collaborative work environment and innovate on new analytical capabilities
• Work closely with cross-functional teams, including pricing, finance, Health Solutions and Risk Adjustment operations to support business objectives
• Monitor current and emerging regulatory pertaining to healthcare cost and risk adjustment, communicate of these developments to relevant stakeholders, and ensure processes and procedures are consistent with changing regulations
• Ensure compliance with all relevant actuarial standards, statue and regulations, and company policies. Identify and mitigate risks associated with actuarial processes and methodologies. Ensure timely tracking of results and course correction activities as needed

Your Knowledge and Experience

 

• Requires a bachelor's degree in actuarial science, mathematics, statistics, computer science or related field and 12 years prior relevant job including 6 years of management experience
• Requires Director-level knowledge in 2 or more of the following health insurance actuarial functions: reserving, cost of healthcare trend analysis, pricing, population risk scores and cost-benefit analysis
• Requires an ASA however, a Fellow of the Society of Actuaries (FSA) or equivalent professional designation is preferred
• Requires one to meets or will meet US Qualification Standards for signing an NAIC Statement of Actuarial Opinion upon completing applicable continue education requirement
• Requires strong analytical and problem-solving skills, with proficiency in actuarial modeling and data analysis tool
• Requires excellent leadership and team membership abilities
• Requires ability to work effectively in a cross-functional, dynamic environment and drive for actions