Actuarial Services Manager - Corporate

This position is responsible for managing the actuarial components of financial reporting and analysis cycles within the organization.

Responsibilities

• Work with the Director, Actuarial Services to manage the development and communication of actuarial analysis related to financial reporting in alignment with organizational vision and goals.
• Develop and maintain models to determine actuarial estimates of Incurred But Not Reported (IBNR), Premium Deficiency Reserve (PDR) liabilities, and other assets and liabilities; manage regular processes to ensure financial reporting deadlines are met.
• Develop and maintain actuarial cost models to perform cost and utilization analysis; identify and explain key drivers of historical trends; gather and develop benchmarks for purposes of assessing performance and the potential for improvement.
• Lead trend forecasting for use in budgeting; work with Financial Planning & Analysis team to set budgeted utilization and cost targets and evaluate actual results against budget.
• Analyze financial performance and work with LOB Finance team to communicate results and drivers of historical and forecasted performance to business leaders; identify opportunities to influence current and future outcomes.
• Create models of proposed interventions for use in goal setting, budgeting, and forecasting.
• Oversee the design, development, and implementation of evaluation tools to measure the effectiveness and ROI of various programs.
• Drive strategic use of data to support business efficiencies and competitive decision-making.
• Ensure the timely completion of assigned regulatory reporting for CMS and OHA.
• Communicate effectively, encouraging and creating a collaborative culture within Strategic Finance and cross-functionally.
• Build and ensure effective relationships across internal teams and external organizations for current or future integration.
• Partner with internal leaders and managers in identifying improvement plans and processes.
• Manage team(s) and recommend team direction and goals in alignment with the organizational mission, vision, and values.
• Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens.
• Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations.
• Participate in 1:1, team, and department meetings; attend all staff meetings.
• Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
• Train, supervise, motivate, and coach employees; provide support toward employee development.
• Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making.
• Ensure team adheres to department and organizational standards, policies, and procedures.
• Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
• Perform supervisory tasks in collaboration with Human Resources as needed.

Requirements

• Minimum 5 years’ experience in actuarial services related to health care
• Work experience in health insurance
• Associate of the Society of Actuaries

Preferred Qualifications

• Minimum 2 years’ experience in a supervisory position or minimum 1 year experience in a supervisory position with completion of CareOregon’s Aspiring Leaders Program
• Fellow of the Society of Actuaries
• Experience with Medicaid and Medicare
• Experience estimating IBNR, risk adjustment transfers, and other health care liabilities and assets
• Experience analyzing health care cost and utilization data

Skills

Required Knowledge

• Extensive knowledge of managed care and the Oregon Health Plan
• Knowledge of various methods of estimating IBNR and other reserves
• Ability to construct and use actuarial cost models for performing cost and utilization, trend, and benchmarking analysis
• Understanding of how to model direct and indirect financial impacts in a complex system
• Strong understanding of data systems and relational databases

Required Skills and Abilities

• Proficient with SAS, SQL, and/or R
• Advanced Excel skills
• Excellent critical thinking and problem-solving skills
• Effective leadership skills and advanced understanding of managerial concepts and techniques in areas such as work planning, training, delegating, coaching, mentoring, and evaluating staff
• Ability to develop and assess actuarial analyses and models pertaining to managed care
• Ability to communicate effectively, both verbally and in writing, including strong presentation skills
• Ability to develop and lead high performing team members, including hiring, goal setting, coaching, performance management, and career development
• Ability to develop and maintain Tableau dashboards
• Ability to work with eligibility data, claims data, risk scores, and other financial data
• Ability to work in an environment with matrix reporting, diverse individuals, and groups
• Ability to identify, implement, and manage process improvements
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movement for at least 6 hours/day

Working Conditions

• Work Environment: Indoor/Office
• Member/Patient Facing: No
• Hazards: May include, but not limited to, physical and ergonomic hazards
• Equipment: General office equipment
• Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used
• Work Location: Work from home

Pay

Estimated Hiring Range: $170,460.00 - $208,340.00

Bonus Target: 5% Annual (SIP Target)

Benefits

• Competitive pay and bonus opportunity
• Comprehensive benefits package, including:
  • Medical, dental, vision, life, AD&D, and disability insurance
  • Health savings account, flexible spending account(s), lifestyle spending account
  • Employee assistance program and wellness program
  • Discounts and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
• Strong retirement plan with employer contributions
• Paid Time Off (PTO) and Paid State Sick Time accrual based on hours worked/scheduled hours and the primary work state
• Paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility