Job Description:

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

Director & Actuary Government Markets is responsible for management of Government Markets’ pricing and analysis functions for Independence Blue Cross’ (IBC) Pennsylvania and New Jersey business. This includes serving as the lead actuary for the Medicare business, providing direction and leadership to financial decisions and serving as a liaison for the Actuarial Department to the Government Markets organization.

1. Lead and supervise the analysis of historical claims experience, project anticipated costs, and develop rate recommendations in support of all Medicare offerings, including Medicare Advantage, Part D and Medicare Supplement. Support the attainment of profitability goals through adequate pricing for expected medical, administrative, and risk charges. 


2. Manage rate filings and other related requests of CMS and the Pennsylvania Insurance Department (PID). This includes the development of bid packages, rate filings, and support for CMS and PID inquiries. This also includes managing and coordinating outside consulting support and periodic audits by CMS. Look for opportunities to improve the effectiveness of tools and drive for greater accuracy and automation.


3. Provide financial leadership for Government Markets by driving improvements in profitability and monitoring of emerging financial results. Improve awareness of financial drivers and offer solutions for improvement.


4. Create and maintain group rating models for use by Underwriting. Support key customer negotiations, pricing methodology, and recommend changes to methodology as business needs develop.


5. Partner with Government Markets to understand the competitive environment and changing regulatory requirements in order to develop effective strategies. Analyze competitive rate and product information and suggest pricing changes to improve IBC’s positioning.


6. Support and influence the development of new Medicare offerings as business needs arise. Ensure new products are priced appropriately and support the overall profitability goals of the book of business. Support new projects as business needs demand.


7. Support the annual planning (AOP) and forecasting process, including revenue and margin assumptions and reviewing reasonability of forecasts. 


8. Manage Actuarial staff to achieve these deliverables. Support their career development.

QUALFICATONS

• Bachelor's degree in Mathematics, Statistics, Economics or Actuarial Science


• Fellowship in the Society of Actuaries 


• Prior supervisory experience required


• 10+ years of healthcare industry experience preferred


• 6+ years of Medicare Advantage experience preferred


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  Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

  
  

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

 Bachelor's degree in Mathematics, Statistics, Economics or Actuarial Science

• Fellowship in the Society of Actuaries 


• Prior supervisory experience required


• 10+ years of healthcare industry experience preferred


•  6+ years of Medicare Advantage experience preferred

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

 

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