Summary
 

Directs and supervises Large Group actuarial staff to provide actuarial reporting, analysis and recommendations that will produce profitable revenue growth in support of the business unit objectives.

Description
 

• Directs and supervises assigned actuarial staff in development of product design, large group manual rates, pricing recommendations, reinsurance analysis, stop loss pricing, discount analysis, claim repricing, and underwriting support.

• Manages renewal and new business pricing systems for large group insured business.

• Incorporates the results of trend analysis and other pricing factor analysis into rating manuals.

• Manages specific case pricing requiring in depth studies for National Alliance and large group ASO business.

• RFP and value-based provider arrangement support for current and potential large group clients.

• Provides other actuarial analysis for policy, operational, and rating decisions.

• Projects financial results and monitors actual financial results.

• Provides actuarial services to smaller wholly owned subsidiaries.

• Provides support for rate filing submissions as required.

• Hire and maintain a competent staff, which includes interviewing and selection of personnel, completing performance reviews, counseling staff, and other administrative matters.

Required Education: Bachelor's degree – Actuarial Science, Math, Statistics, or related field with an ASA or a Bachelors Any Major with an FSA.

Required Work Experience: 10 years FSA (Fellowship of the Society of Actuaries) health actuarial experience or 13 ASA (Associate of the Society of Actuaries) health actuarial experience.

Required Skills and Abilities: Extensive expertise in actuarial theory and practical applications relative to the health insurance industry, particularly with respect to rating, reserving, risk assessment, and forecasting. Knowledge of health insurance products, including benefits, contract provisions, marketing and underwriting, and regulatory requirements. Knowledge of statutes, regulations, and regulatory filings relative to the health insurance industry. Knowledge of the Actuarial Standards of Practice. Ability to communicate well with senior management, consultants, other insurers, regulators, legislators, CMS, and other government contractors. Ability to use sound reason and deduction to deal with highly unusual and sensitive circumstances. Ability to analyze and interpret laws and regulations. Good organizational skills. Ability to meet deadlines. Ability to handle confidential or sensitive information with discretion.

Required Software and Other Tools: Microsoft Office.

Required Licenses and Certificates: Member of the American Academy of Actuaries. Completion of examinations leading to Associateship or Fellowship in the Society of Actuaries. Annual completion of qualification / continuing education requirements of the American Academy of Actuaries.

Preferred Work Experience:

15 years-ASA (Associate of the Society of Actuaries) health actuarial experience.

Work Environment: Typical office environment.

 

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Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.