Actuarial Manager of Senior Markets Pricing Job Listing at BCBSM in Detroit, MI (Job ID COR00068)

Blue Cross Blue Shield of Michigan

BCBSM

Location: Detroit, MI
Application deadline: None
Type: Not specified
Career Level: Not specified
Salary Range: Not specified
Number of Jobs: 1
Relocation Available: No
Show all jobs for BCBSM
Industries
Healthcare, Insurance
Description
In this position, you will serve as the Manager, Senior Markets Pricing Actuary, with responsibility for design, pricing and implementation of Medicare Advantage and Medigap products ensuring compliance with state and federal regulations.  Specifically, you will:
 
Work on developing program rates; preparing cost estimates; conducting and evaluating surveys; directing studies on prices, utilization, and costs related to health care costs and providing consultative services on matters relating to our Senior Market products.
 
Other responsibilities will be planning, organizing, managing and leading a team of actuaries.  Set vision and identify strategic direction for the team, Support corporate goals and objectives.  Work with a variety of internal business partners. 
 
 
Direct and provide leadership in the design, pricing and implementation of products ensuring compliance with various state and federal regulations.
 
Plan and carry out projects using advanced level of knowledge and comprehensive understanding of complex actuarial principles and practices to resolve a variety of problems in the absence of guidelines or precedents.  Utilize significant discretion in order to achieve necessary results. Evaluate product line performance and the risk and appropriateness of assumptions used in product development. Make initial determinations on reserves, dividends allocations and surplus forecasts. Analyze the financial risks for various asset/liability matching scenarios and monitor the appropriateness of reserves. May supervise several intermediate level professionals. Other duties may be assigned.

  • Bachelor's Degree in Mathematics or related area required.
  • Minimum of five (5) years actuarial experience, including one (1) year at the Assistant Actuary level or comparable experience at another company.
  • Earned the ASA designation.  FSA designation would be a plus.
  • 2 years in a Management role.
  • Responsibility for overseeing production of bids for MA products, including PDP, PPO and HMO.  Responsibility for state Medigap filings.
  • Knowledge and comprehensive understanding of complex actuarial principles and practices.
  • Strong analytical, verbal and written communication skills.
  • Other related skills and/or abilities may be required to perform this job.

LEADERSHIP EXPERIENCE

 

Will have management responsibilities such as - interviewing, hiring and training employees; planning, assigning, and managing work; appraising performance; rewarding and disciplining employees and addressing and resolving problems.

 

Ability to be self critical and look for opportunities to improve.

 

DEPARTMENTAL REQUIREMENTS

 

Experience with Medicare Part C and Part D is required.

 

Maintain product expertise through attendance at industry meetings, listening to customers and agents and maintaining knowledge of regulatory requirements.

 

Stay abreast of CMS regulations.

 

Demonstrated ability to communicate actuarial analysis to non-actuaries is essential.

 

Experience creating and analyzing experience reports and developing assumptions for pricing the Medicare Part C and Part D business.

 

Experience evaluating and developing monthly financial projections.

 

Experience analyzing and projecting membership mix changes and consumer behavior.

 

Have maintained models for member and population level outcomes analysis.

 

Design, develop and managed special actuarial studies and projects on topics such as formulary impact, rebates, risk adjusters, persistency, and the development of pure premium estimates from loss distribution modeling and analysis.

 

Have significant business intelligence and domain expertise to project claims, discounts, risk scores, membership, admin, and rebates.

 

Previous experience working in an integrated fashion with other areas of the Actuarial department.

 

The ability to maintain strong, working relationships with internal stakeholders.

 

The ability to create and support cooperative working relationships, both within the company-at-large and with outside business partners.

 

Demonstrated previous implementation, execution, innovation, problem solving skills meaning, you can demonstrate you are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.

 

You can introduce new ideas and processes which improve performance and productivity.  You are a problem solver with the ability to encourage others in collaborative problem solving ways.  Acting as both a broker and consultant regarding resources, you engage others.

 

 

 

 

 

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