Dir Actuarial Services (Life)

Admin — Thu, 03 Jul 2008 11:29:15 GMT

Position: Dir Actuarial Services

Company: Insurance Organization

Location: Arizona

Job ID: 14410

RESPONSIBILITIES:

- Provide actuarial direction and strategy to actuarial pricing team supporting managed care rate development for Medicaid programs.
- Lead actuarial analysis and services in support of medical analysis, trend projections, and rate negotiations.
- Analyze financial and claims data to evaluate utilization and unit price trends.
- Design and oversee ad hoc health cost analyses.
- Price products consistent with financial and business objectives.
- Balance growth and profitability goals to maximum results.
- Assist and participate in negotiations and presentations where appropriate.
- Develop the organization's premium rate structure through regular and systematic analysis of experience and forecasting of financial/statistical data in a manner which is actuarially sound, competitive in the marketplace, and provides income in accordance with organization goals and objectives. Includes proforma development, cash flow analysis, and financial projections.
- Responsible for the preparation of required rate filings and supporting experience exhibits.
- Train and manage actuarial/pricing staff.

QUALIFICATIONS:

- Bachelors or Master's degree
- Actuarial/Finance/Math background
- Fellowship in the Society of Actuaries
- Good standing as MAAA
- Managed Care experience, Reinsurance & Stop Loss
- 5+ yrs underwriting /actuarial experience in healthcare, prefer Medicaid managed care environment, large case pricing, manual rate development.
- Thorough knowledge of CMS Medicaid Managed Care regulations affecting capitation.
- In-depth knowledge of Medicaid claims and encounters, Medicaid enrollment data, and Medicaid financial reporting.
- Familiarity with various diagnostic-based risk adjustment models.
- Experience with development of trends, program change factors, and utilization and unit cost assumptions.
- In depth understanding of health care industry and trends.
- Extensive understanding of Medicaid managed care rate setting methodologies and strategies.
- In-depth knowledge of underwriting principles and practices.
- Good presentation skills.
- 5+ years of management experience overseeing actuarial/pricing staff.
- Proficient in Word and Excel.

Online Application available at www.jobs4actuary.com

For further information, email info@nasearchg.com and mention Position #14410, or contact any of our recruiters at (905)-477-2962.

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Dir Actuarial Services (Life)