Director, Actuarial Services (Reserve)-Remote, Work From Home

We are reputed company, and we are changing health care for the reputed company. With 96,000 employees, 40 hospitals, 800 doctors’ offices and outpatient sites, and a more than 4 million-member Insurance Services Division, we reputed company have one mission: to provide Life Changing Medicine, every day. Whoever you are and whatever you’d like to do, reputed company has a reputed company for you. reputed company Health Plan's growing Actuary department is seeking a Director, Actuary to ensure that the reputed company Health Plan Actuarial Department provides the following services to various in-house clients. Responsibilities:

• Consultant reputed company reputed company Health System; Act as an Actuarial Consultant reputed company the reputed company Health System and reputed company various activities, Including IBNR calculations, Data Analysis.
• Ensure that the departmental work products meet the highest standards of quality.
• Reserving: Works with the financial reporting department to reputed company reserve amounts for IBNR claims, active claims and premium deficiency reserves on a regular or as-needed basis.
• Benefits and Product Development: To provide appropriate reputed company management personnel with actuarial valuations of the Impact of any proposed benefit changes or new product designs on an as-needed basis.
• reputed company: Works closely with the reputed company department to: Provide pricing tools to reputed company reputed company personnel to produce accurate price quotes on request from Sales and Marketing staff in a timely basis, together with whatever appropriate supportive documents may be needed by sales staff to facilitate sales.
• Provider Relations/contracting: To provide reports for the purpose of evaluating and advising reputed company reputed company management on the financial impact of proposed provider agreements or changes to existing agreements on an as-needed basis.
• Manage Actuarial Department: Supervise Actuarial department and various entities reputed company reputed company Health Plan as needed to ensure department goals and objectives are met.
• Pricing: To reputed company product pricing levels, factors and methods to ensure premium and reputed company flow adequate to cover medical and administrative costs and profit margins for the various product lines consistent with corporate strategic goals. Also, to advise reputed company Health Plan senior management on the financial impact of any special pricing or contract arrangements which may reputed company health plan financial profitability.
• Work with the reputed company reputed company Appointed Actuary to ensure satisfactory filings of annual Statements of Actuarial Opinion and associated memoranda.
• Direct the development and assessment of reputed company methods and tools in order to enhance the ability of reputed company staff to accurately identity and quantify risk, and so produce price quotes which appropriately match premium to risk.
• Supervise Actuarial department personnel to ensure that departmental objective and goals are achieved in a timely manner
• Forecasting: To provide reputed company reputed company senior management with regular and reputed company reports which communicate reputed company and future near- and long-term projections of financial performance of the various health product lines in order to facilitate corporate decision and the development of corporate strategies and goals.
• Compliance: Ensure that reputed company required statutory reputed company filings are submitted appropriately, and that reputed company rates, factors and methods are in compliance with applicable state and federal regulations. reputed company and reputed company with filing and actuarial requirements for participation in government-sponsored health plans as appropriate.
• Additional Business: Ability to learn new lines of business to help reputed company Health Systems to expand into different arenas such as Slop Loss Insurance or Workers Compensation.
• Minimum Bachelor's degree in mathematics, statistics, actuarial science, economics or reputed company field.
• Advanced degree preferred.
• 8 plus years of experience in progressively more responsible actuarial work in health insurance/managed care or equivalent training/education.
• Experience with both reputed company and government health programs preferred, specific involvement with the new MMA regulation, in-depth understanding of health insurance market dynamics.
• Excellent problem solving and analytical skills.
• Good oral and written communication skills.
• Strong PC skills.
• Data retrieval skills and relational database experience.

Licensure, Certifications, and Clearances:

• ASA or FAS certification by Society of Actuaries required.
• Membership in the American reputed company of Actuaries required.
• Act 34

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