Actuarial Svcs Trend & Network Mgr

About the role

As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community. This role leads the development and oversight of key actuarial functions that support the organization's financial performance and strategic decision-making.

Responsibilities

• Lead actuarial analyses related to pricing trends, network and area factors, provider performance, Medicare Advantage, forecasting and other healthcare actuarial initiatives.
• Manipulate and analyze data using SQL, Databricks and Excel.
• Maintain and improve the Pricing Trend methodology, process, and documentation.
• Maintain and improve the Network/Area factors methodology, and Provider entity performance analysis and documentation.
• Oversee the monthly Medicare Advantage IBNR, Quarterly & Annual Statement, Risk Adjustment analysis and other related projects.
• Serve on cross-functional teams to represent actuarial point of view.
• Support the Bid process.
• Support the corporate reinsurance program, such as renewal, monthly reporting, and filing for reimbursement.
• Provide VBC Trend and support other VBC activities.
• Manage the Actuarial Services department workflows.
• Prepare and present reports to internal management.

Requirements

• Bachelor's degree in actuarial science, Mathematics, Statistics, or related field.
• Five years of experience in an actuarial role and three years of experience in the health care industry.
• ASA Licensure/Certification.
• The ability to meet or exceed the attendance and timeliness requirements of their departments.
• The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.

Qualifications

• Three (3) years of leadership experience.
• Experience leading healthcare actuarial analyses and developing actuarial methodologies.
• Strong communication and presentation skills, including the ability to explain complex findings to business and executive leadership.
• Experience improving actuarial processes through automation, artificial intelligence, or advanced analytics.

Skills

• SQL
• Databricks
• Excel

Benefits

To Be Considered For This Position, You Must Have...

Pay

TBD

Schedule

TBD

Benefits

TBD

Application Instructions

To apply, visit NebraskaBlue.com/Careers.

Equal Opportunity Employer

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.