Actuarial Analyst IV Medicare Advantage Bid

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Job Summary :

This role will be a part of the newly created Medicare Transform team and will support the actuarial bid pricing process for Horizon’s joint venture Medicare lines of business, in addition to providing detailed forecasts, conducting and tracking profitability analyses, and authoritatively communicating results and providing reporting to stakeholders and senior leadership.

Responsibilities :

• Support actuarial pricing for the Medicare Advantage bid process, working in conjunction with department leadership.
• Support developing a robust suite of internal tools for the bid process, member-level and cohort-level profitability analysis, and detailed forecasting.
• Forecasting and profitability analysis.
• Perform other ad-hoc analyses as requested (examples include assessing the impact of Star rating changes, benefit changes, or other changes).
• Investigate and communicate variances and drivers of forecasts to department leaders.
• Provide strategic thinking regarding the overall business strategy, incorporating product knowledge and broad Medicare Advantage landscape market dynamics.
• Supervise and train junior actuaries as needed.

Disclaimer :

This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification.

It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Education / Experience :

Bachelors degree, required preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university.

Requires 5+ years of Actuarial and / or statistics experience, and the attainment of Associate level in the Society of Actuaries (ASA), or attainment of Fellowship level in the Society of Actuaries (FSA).

Experience in health insurance is preferred.

4 years Medicare Advantage actuarial bid pricing preferred.

Additional licensing, certifications, registrations :

ASA Required

Knowledge

Requires expert knowledge of Excel.

Prefers working knowledge of Access or other database applications.

Prefers experience with SAS or other programming languages.

Requires strong working knowledge of data analysis and Actuarial principles.

Requires in-depth knowledge of the healthcare industry.

Skills and Abilities :

Requires excellent oral and written communication skills.

Requires strong analytical thinking.

Requires strong mathematical skills and statistical analysis abilities.

Requires good judgment and problem solving skills.

Requires strong leadership skills.

Salary Range : $110,300 - $150,570

$110,300 - $150,570

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to : education, experience, licensure, certifications, geographic location, and internal equity.

This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case.

Horizon also provides a comprehensive compensation and benefits package which includes :

Comprehensive health benefits (Medical / Dental / Vision)

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.

Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.