Dir - Actuarial Services

2 months ago

Phoenix, Arizona, United States Blue Cross Blue Shield of Arizona Full time
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

This position requires work and residency within the state of Arizona.

Purpose of the job

This position requires the ability to provide and oversight on Actuarial concepts and technical analysis on projects related to the Premium Development area of Actuarial Services that include, but are not limited to the following:

Pricing
  • Overall responsibility for determining adequate and competitive premium levels for Blue Cross and Blue Shield of Arizona's Commercial, Individual and Government Segments, more than $3.955 billion in annual revenue (as of Responsible for comparing actual experience to expected projections, determining the differences, and recommending corrective actions.
Product Development and Benefit Modifications
  • In coordination with Sales, Marketing and Executive Management, develop the premium levels for all new products, taking into consideration the following: market placement of product, competitive products already in existence, and effect of selection and moral hazard on benefit design. Develop price adjustments for all group and non-group benefit adjustments taking the concerns listed above into consideration.
Group Rating Factors
  • For commercial segment, monitor and determine the necessary adjustments to rating factors used by Underwriting in their rating analysis. This list includes, but is not limited to the following: group base rate tables, medical and COBRA loads, size loads, industry loads, benefit plan factors, age relativity factors, aggregate and specific stop-loss rates, retention accounting risk charge and credibility factors
Trend Analysis
  • Overall responsibility to evaluate the group medical trends to determine adequacy of group rating trends. The evaluation should encompass the impact of technological changes, contracting changes and benefit changes.
  • Responsible for determining adequate and competitive premium levels for Blue Cross and Blue Shield of Arizona's Commercial, Individual and Government Segment business, more than $3.9 billion in annual revenue (as of 2020).
Qualifications
  • General knowledge of the health care industry, knowledge of the principles and methods of organization and management
  • Knowledge of the principles and practices of mathematics and statistics as related to actuarial work
  • Knowledge of actuarial techniques and the development of rate schedules and payment methodologies for health care prepayment coverage
REQUIRED QUALIFICATIONS

Required Work Experience
  • A minimum of five years of actuarial experience in a health care prepayment organization, typically attained at the Actuary II level and above
Required Education
  • Bachelor's degree in Mathematics, Statistics, or other degree with major emphasis in mathematics or statistics
Required Licenses
  • N/A
Required Certifications
  • Associate of the Society of Actuaries and /or Member of the American Academy of Actuaries required.
PREFERRED QUALIFICATIONS

Preferred Work Experience
  • N/A
Preferred Education
  • N/A
Preferred Licenses
  • N/A
Preferred Certifications
  • Fellow of the Society of Actuaries desired.
ESSENTIAL job functions AND RESPONSIBILITIES
  • Personally conducts or supervises:
    • Calculations for rate determinations and preparation of Department of Insurance filings for all existing and new Individual products.
    • Updates and development of all group rating factors, such as administrative retention allowances, trend projections, completion factors, deductible tables, rating manuals, etc.
    • Development and maintenance of all capitation rates.
    • May be responsible for the development of financial modeling and reporting for budgetary, strategic planning, and rating purposes.
    • May be responsible for the estimation of corporate unpaid claims liabilities.
    • Development of extensive, complex programs for the personal computer to ensure accurate and timely completion of tasks.
    • Coordination of all system changes, upgrades, and CSR modifications for the Actuarial department reporting.
  • Participates in the development and review of long-range financial plans and policies.
  • Coordinates the activities of the Actuarial Services department with other divisions on interrelated matters.
  • May include maintenance of relationships with other Blue Cross and Blue Shield plans and with other agencies in the field of health care economics or prepayment and with the Blue Cross and Blue Shield Association on actuarial activities and issues.
  • Participates in the development of new products or modifications to existing products.
  • May include working with EDS, Information Services, and other personnel and utilizes internal programming capabilities toward the design, development and maintenance of the actuarial and underwriting data systems.
  • Comply with BCBSAZ Computer Responsibility Agreement. Employees with Internet access are required to comply with the Internet Policies Agreement.
  • Apply appropriate security and privacy measures to all tasks.
Competencies

REQUIRED COMPETENCIES

Required Job Skills
  • N/A
Required Professional Competencies
  • Comply with BCBSAZ Computer Responsibility Agreement. Employees with Internet access are required to comply with the Internet Policies Agreement.
  • Apply appropriate security and privacy measures to all tasks.
Required Leadership Experience and Competencies
  • Skill in oral and written communications
  • Ability to establish and maintain effective relationships with others.
  • Strong leadership skills to manage and develop the Actuarial Services team.
PREFERRED COMPETENCIES

Preferred Job Skills
  • N/A
Preferred Professional Competencies
  • N/A
Preferred Leadership Experience and Competencies
  • N/A
Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see If interested in this position, please apply.

  • Truck Driver

    7 days ago

    Phoenix, Arizona, United States DIR Holdings LLC Full time

    About DIR Holdings LLCDIR Holdings LLC is a privately owned, purpose-driven industrial construction company that has a unique, opportunistic, and growth-oriented culture.Our PurposeTo acknowledge and glorify God by living in submission to Him as we steward His resources, giving Him thanks through the meaningful work we do, and directing the profits of our...

  • Junior Government Healthcare Actuary

    2 months ago

    Phoenix, Arizona, United States Marsh & McLennan Companies, Inc. Full time

    Company: Mercer Description: At Mercer, our mission is to positively impact people's lives by promoting their health, wealth, and careers. Mercer is looking for candidates for the Junior Government Healthcare Actuary position. Our main offices are situated in Phoenix, Atlanta, DC, and Minneapolis. Junior Government Healthcare Actuary Responsibilities:Work...

  • Junior Government Healthcare Actuary

    3 months ago

    Phoenix, Arizona, United States Mercer Full time

    At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is seeking candidates for the Government Healthcare Actuary position. Our primary offices are located in Phoenix, Atlanta, DC, and Minneapolis.Junior Government Healthcare ActuaryWe will count on you to: Serve as actuary on...

  • Government Healthcare Actuarial Manager

    3 months ago

    Phoenix, Arizona, United States Mercer Full time

    At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is currently recruiting for a Government Healthcare Actuarial Manager to work in one of the following offices: Phoenix, Atlanta, or Minneapolis.Government Healthcare Actuarial ManagerWhat can you expect? Be a part of the team...

  • Associate Actuary

    14 hours ago

    Phoenix, Arizona, United States USAA Full time

    About the RoleAs a dedicated Associate Actuary within a Specialty Lines team at USAA, you will play a critical role in developing and implementing actuarial analyses and strategies to support the company's mission and goals.Key ResponsibilitiesEstablish statistical plans, analytical tools, and requirements for analyzing product experience, classification...

  • Associate Actuary

    14 hours ago

    Phoenix, Arizona, United States USAA Full time

    About the OpportunityAs a dedicated Associate Actuary within a Specialty Lines team at USAA, you will have the opportunity to work on a variety of projects, including Renters, Umbrella, Valuable Personal Property (VPP), and Rental Property (RPI).Key ResponsibilitiesCoordinate, prepare, and perform advanced actuarial analyses to develop new products, project...

  • Actuary (Specialty Lines Pricing) - Data Analyst

    4 days ago

    Phoenix, Arizona, United States USAA Full time

    About the RoleUSAA is seeking a highly skilled Actuary (Specialty Lines Pricing) to join our team. As a key member of our Specialty Lines Pricing team, you will be responsible for coordinating, preparing, and performing advanced actuarial analyses to develop new products, project future results, reprice existing products, and determine financial strength.Key...

  • Director, Pricing and Actuarial Leadership

    6 days ago

    Phoenix, Arizona, United States USAA Full time

    About the OpportunityThis is a leadership role that requires a seasoned actuary to oversee the development of product line pricing assumptions and price structure while ensuring price level objectives are met.The ideal candidate will have experience with actuarial analysis regarding claims or loss trends, presenting claims stories to internal business...

  • Director, P&C Pricing and Reserving Actuary

    1 week ago

    Phoenix, Arizona, United States USAA Full time

    Director, P&C Pricing and Reserving ActuaryUSAA is seeking a highly skilled Director, P&C Pricing and Reserving Actuary to lead a team of actuarial professionals in analyzing and achieving target pricing levels, developing new products and rating structures, and ensuring alignment with market and financial goals.Key Responsibilities:Oversee the development...

  • Government Healthcare Data Consultant

    1 month ago

    Phoenix, Arizona, United States Mercer Full time

    At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is seeking candidates for the Government Data Consultant position. Our primary offices are located in Phoenix, Atlanta, and Minneapolis.Government Data Consultant We will count on you to:Utilize SAS programming software to...

  • Senior Government Consultant

    2 months ago

    Phoenix, Arizona, United States Mercer Full time

    At Mercer, our purpose is to make a positive difference in people's lives by helping advance their health, wealth, and careers. Mercer is seeking candidates for the Government Data Consultant position. Our primary offices are located in Phoenix, Atlanta, DC, and Minneapolis.Senior Government Data Consultant We will count on you to: Utilize SAS programming...

  • Government Healthcare Financial Consultant

    7 days ago

    Phoenix, Arizona, United States Marsh & McLennan Companies Full time

    About the RoleMercer, a leading global consulting firm, is seeking a skilled Government Healthcare Financial Consultant to join our team. As a key member of our Government Human Services Consulting (GHSC) team, you will work closely with state governments to examine financial reports and provide expert analysis to ensure efficient use of Medicaid dollars.Key...

  • Fraud Prevention Strategist

    7 days ago

    Phoenix, Arizona, United States USAA Full time

    About the RoleAs a dedicated Fraud Strategy & Analytics Analyst II at USAA, you will play a critical role in providing decision support for business areas across the enterprise.Key ResponsibilitiesApply mathematical and statistical techniques and/or innovative/quantitative analytical approaches to draw conclusions and make 'insight to action' recommendations...

  • Government Healthcare Financial Consultant

    7 days ago

    Phoenix, Arizona, United States Marsh & McLennan Companies Full time

    About the RoleMercer, a leading global consulting firm, is seeking a skilled Government Healthcare Financial Consultant to join our team. As a key member of our Government Human Services Consulting (GHSC) team, you will work closely with state governments to examine financial reports and provide expert analysis to ensure efficient use of Medicaid dollars.Key...

  • Government Healthcare Financial Consultant

    6 days ago

    Phoenix, Arizona, United States Marsh & McLennan Companies Full time

    About the RoleMercer, a leading global consulting firm, is seeking a skilled Government Healthcare Financial Consultant to join our team. As a key member of our Government Human Services Consulting (GHSC) team, you will work closely with state governments to examine financial reports and provide expert analysis to ensure efficient use of Medicaid dollars.Key...

  • Child Development Psychologist

    7 days ago

    Phoenix, Arizona, United States Southwest Human Development Full time

    About the RoleSouthwest Human Development is seeking a highly skilled and dedicated Early Childhood Development Specialist to join our team. As a key member of our team, you will play a vital role in promoting the health and development of young children and their families.Key ResponsibilitiesParticipate in transdisciplinary team assessments to identify the...

  • Revenue Cycle Manager

    6 days ago

    Phoenix, Arizona, United States GPW and Associates Full time

    Job DescriptionAt GPW and Associates, we are dedicated to delivering exceptional client experiences. As a leading provider of management, accounting, and tax compliance services, we specialize in supporting Producer Affiliated Reinsurance Companies in the automotive and banking sectors. We also serve Captive Insurance Companies across diverse industries and...

  • Healthcare Financial Operations Manager

    2 weeks ago

    Phoenix, Arizona, United States CFA Institute Full time

    Company:CFA InstitutePosition Overview:At CFA Institute, we are dedicated to enhancing the financial well-being of individuals and organizations by providing expert guidance in the realms of finance and investment.We are currently seeking qualified candidates for the role of Healthcare Financial Operations Manager. This position offers flexibility for remote...

  • Senior Advisor for Government Healthcare Financial Solutions

    2 weeks ago

    Phoenix, Arizona, United States Marsh & McLennan Companies Full time

    Company: Marsh & McLennan Companies Position Overview: At Marsh & McLennan, we are dedicated to making a meaningful impact on individuals' lives by enhancing their health, wealth, and career trajectories. Role: Senior Government Healthcare Financial Consultant What to Expect: We focus on empowering government-sponsored initiatives to optimize their...

  • Revenue Cycle Management Specialist

    2 weeks ago

    Phoenix, Arizona, United States GPW and Associates Full time

    Job OverviewAt GPW and Associates, we are dedicated to providing exceptional client experiences since our inception in 1998. As a prominent provider of management, accounting, and tax compliance services, we focus on assisting Producer Affiliated Reinsurance Companies within the automotive and banking industries. Our expertise also extends to Captive...