Director, Actuarial Services - Commercial & Medicare Products

Position Summary/Position

This Director is responsible for pricing, performance management, and forecasting for IEHP’s Medicare and Commercial (i.e., Covered CA) line of business.  This includes, but not limited to, the development of product analytics to define and measure the financial performance and providing actuarial support to other business units for the two lines of business. This position collaborates with other IEHP business units in planning and developing strategies to maximize the financial performance. This leader will oversee credential actuaries and actuarial team members to support the department functions.

Major Functions (Duties and Responsibilities)

1. Lead development of pricing, experience analysis, and financial forecast modeling for the assigned lines of business
2. Develop product analytics to define and measure financial performance 
3. Oversees development for Medicare bids, regulatory rate filings and other required regulatory submissions for the assigned lines of business 
4. Collaborate with IEHP business units in planning and developing strategies to maximize the financial performance
5. Communicate clearly and present appropriate level of information to senior leaders
6. Research, evaluate and analyze the market landscape for the assigned lines of business
7. Lead a team of analysts to ensure cohesive team culture and effective collaboration with other business units
8. Manage the respective actuarial service unit including recruiting, training, and coaching Team Members.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Experience Qualifications

Minimum ten (10) years of actuarial experience in Health Care industry. Proven strategy actuarial or analytic leadership experience in working with cross-functional teams. Data analysis experience in a healthcare setting. Five (5) years of managing experience is required.

Preferred Experience

Medicare and/or ACA experience is preferred.

Education Qualifications

Bachelor’s degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is required.

Preferred Education

Professional Certification

Associate of the Society of Actuaries (ASA) is required; Fellow of the Society of Actuaries (FSA) is preferred.

Professional Licenses

Drivers License Required

Knowledge Requirement

Principles and practices of managed health care industry and strategies. Strong understanding of healthcare market landscape. Knowledge of accounting/finance concepts. Extensive knowledge of MS Excel, Power Point. Knowledge of SQL Programming or relational database is preferred. 

Skills Requirement

Strong conceptual problem-solving skills. Strong quantitative and financial analysis skills. Excellent interpersonal and communication skills (both oral & written). 

Abilities Requirement

Sharp attention to detail, strong work ethic, expansive learner. Ability to work independently and manage a team and take initiative.  Ability to identify and resolve problems, think creatively, strategically and analytically. Ability to apply extensive knowledge of actuarial methods and procedures. Ability to handle multiple competing priorities. Ability to effectively communicate in variety of prestation setting and to influence key stakeholders to drive meaningful change and innovation. Comfortable with senior management audiences, and/or diverse group setting. Strong commitment to quality.  Consistently and thoroughly reviews work for accruing prior to deliverable. 

Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

Work Model Location

Physical Requirements