Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Performs advanced analytics to facilitate fact-based decision-making regarding financial results, strategic planning, and corporate financial soundness.
ESSENTIAL job functions AND RESPONSIBILITIES
- Under close supervision, determine monthly claims liability estimates for certification by the chief actuary.
- Propose and perform analysis of internal and external issues impacting claims payments and processing, which aids in identifying necessary strategic action.
- Coordinate external actuarial consultant quarterly IBNR estimate. Provide actuarial support of internal and external auditors.
- Design and prepare models to establish the amount of capital required to support business considering financial projection assumptions, rating methodology and competitive environment, among others.
- Develop sensitivity testing analysis and summarize results to management.
- Determine necessity and amount of a premium deficiency reserve.
- Perform financial forecast scenario modeling with the perspective of ensuring corporate financial health.
- Analyze and monitor financial results, sources of gain and variances to plan.
- Propose and perform analysis to accurately reflect profitability by line of business.
- Determine the appropriate allocation of administrative expense by line of business for profitability projections.
- Work with underwriting and finance departments to determine adequate rated administrative expense rates for each line of business considering the competitive environment and profitability impact.
- Review admin allocations by line of business for use in profitability projections, tracking sources of surplus/deficiency.
- Prepare analysis and documentation for the actuarial opinion and certification by the chief actuary.
- Perform annual review of Experience-Rated Group (ERG) liability estimate accrual for retention accounting groups.
- Prepare Actuarial portion of financial statements.
- Under general supervision, determine monthly claims liability estimates for certification by chief actuary.
- Display initiative in research beyond the specific assignment
- Pursue expansion of current knowledge and skills.
- Meaningfully contribute to the area’s workload, considering volume and complexity.
- Provide self- and peer-review of level 1.
- Report to a supervisor or manager who provides minimal supervisory instructions, limited project management, and minimal or limited review of results, beyond pre-release peer review.
- Along with research, create analyses and recommendations that will allow BCBSAZ to meet its goals
- Plan and lead complex projects from inception to completion. Includes working independently on creating timelines, working with other areas to define deliverables, monitoring progress, implementing the project and resolving/monitoring post-implementation issues.
- Communicate (both verbally and in writing) and interprets results, recommendations and abstract concepts to internal and external customers. Anticipate and addresses possible customer questions and concerns.
- Incorporate strategic planning in all areas of responsibility.
- Train and mentor other analysts and provide peer review.
- Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned.
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.