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Director, Actuarial Services


Posted: 10/2/2019
Job Reference #: 5000502158006

Job Description

Employment Type


Exempt or Non-Exempt


Job Summary

The Director, Actuarial Services ensures HMSA's financial stability by using sound actuarial principles and judgement. The Director is responsible for the oversight and management of all HMSA's actuarial functions, including trend analysis and projections, pricing, reserving, financial forecasting and financial reporting. He/she also oversees the development and submission of HMSA's required annual actuarial filings, including commercial rate filings and Medicare bid submissions. The Director mentors and leads the actuarial staff who are responsible for carrying out these functions.

Minimum Qualifications

  1. Bachelor's degree in actuarial science, mathematics, statistics, or related field and five (5) years of experience in an actuarial role including a minimum of three years of pricing or underwriting experience or equivalent combination or education and/or experience.
  2. Three (3) years of management experience.
  3. Demonstrated ability to work independently, managing multiple priorities simultaneously and under strict time constraints.
  4. Excellent analytical and problem-solving skills.
  5. Effective communication skills including negotiation, listening, oral and written communication skills, and the ability to explain technical concepts to a non-technical audience.
  6. Demonstrated ability to interact and operate with management and staff at all levels.
  7. Demonstrated ability to effectively manage and develop a team.
  8. Familiarity with health insurance regulations and compliance.
  9. Good working knowledge of Microsoft Office applications, including Word.
  10. Advanced MS Excel skills.
  11. Experience working with database or statistical software.
  12. Associate of the Society of Actuaries (ASA) and a Member of the American Academy of Actuaries (MAAA)

Duties and Responsibilities

  1. Oversee the pricing of HMSA's products for all lines of business, including the following:
    • Pricing of new products/plans/benefits and modifications to existing plans/benefits;
    • Regularly updating the rating methodology and factors for HMSA's non-ACA commercial group lines of business, including drafting and submitting the associated rate filings;
    • Creating and certifying annual ACA individual and small group rate filings;
    • Annually updating grandfathered individual rates and submitting the associated rate filing; and
    • Collaborating with HMSA's actuarial consultant to develop annual Medicare bid submissions and group retiree pricing.
  2. Partner with account management and underwriting staff on new and renewal rating discussions. Provide input regarding underwriting guidelines and procedures. Support the implementation and maintenance of HMSA's commercial group rating engine.
  3. Oversee monthly, quarterly and year-end financial reporting of actuarial and related items, including reviewing the calculation of unpaid claims reserves and ACA-related assets and liabilities.
  4. Create revenue and expense projections at the line of business level. Monitor emerging experience against these projections and produce variance analyses on a regular basis.
  5. Manage staff in the Actuarial Unit, including:
    • Recruit, train and coach staff
    • Develop and implement an actuarial study program to encourage formal actuarial education
    • Ensure that all work is performed in compliance with the applicable Actuarial Standards of Practice and follows industry best practice
    • Implement performance standards and monitor staff performance against the standards, providing regular feedback and coaching in a timely manner; and, implement performance improvement plans as necessary
    • Develop the unit business plan and budget and oversee accurate allocation of unit and departmental costs based on program reporting requirements
  6. Monitor emerging expense trends. Based on these and known/projected provider contract and other key drivers, oversee the development of trend forecasts to be used for financial projections and rating purposes.