Dir - Actuarial Services

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers 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.

This position requires work and residency within the state of Arizona.

Purpose of the job

This position requires the ability to provide and oversight on Actuarial concepts and technical analysis on projects related to the Premium Development area of Actuarial Services that include, but are not limited to the following:

Pricing

• Overall responsibility for determining adequate and competitive premium levels for Blue Cross and Blue Shield of Arizona’s Commercial, Individual and Government Segments, more than $3.955 billion in annual revenue (as of 2020).  Responsible for comparing actual experience to expected projections, determining the differences, and recommending corrective actions.

Product Development and Benefit Modifications

• In coordination with Sales, Marketing and Executive Management, develop the premium levels for all new products, taking into consideration the following: market placement of product, competitive products already in existence, and effect of selection and moral hazard on benefit design.  Develop price adjustments for all group and non-group benefit adjustments taking the concerns listed above into consideration.

Group Rating Factors

• For commercial segment, monitor and determine the necessary adjustments to rating factors used by Underwriting in their rating analysis.  This list includes, but is not limited to the following: group base rate tables, medical and COBRA loads, size loads, industry loads, benefit plan factors, age relativity factors, aggregate and specific stop-loss rates, retention accounting risk charge and credibility factors

Trend Analysis

• Overall responsibility to evaluate the group medical trends to determine adequacy of group rating trends.  The evaluation should encompass the impact of technological changes, contracting changes and benefit changes. 
• Responsible for determining adequate and competitive premium levels for Blue Cross and Blue Shield of Arizona’s Commercial, Individual and Government Segment business, more than $3.9 billion in annual revenue (as of 2020).

Qualifications

• General knowledge of the health care industry, knowledge of the principles and methods of organization and management
• Knowledge of the principles and practices of mathematics and statistics as related to actuarial work
• Knowledge of actuarial techniques and the development of rate schedules and payment methodologies for health care prepayment coverage

REQUIRED QUALIFICATIONS

Required Work Experience

• A minimum of five years of actuarial experience in a health care prepayment organization, typically attained at the Actuary II level and above

Required Education

• Bachelor’s degree in Mathematics, Statistics, or other degree with major emphasis in mathematics or statistics

Required Licenses

• N/A

Required Certifications

• Associate of the Society of Actuaries and /or Member of the American Academy of Actuaries required. 

PREFERRED QUALIFICATIONS

Preferred Work Experience

• N/A

Preferred Education

• N/A

Preferred Licenses

• N/A

Preferred Certifications

• Fellow of the Society of Actuaries desired.

ESSENTIAL job functions AND RESPONSIBILITIES

• Personally conducts or supervises:
  • Calculations for rate determinations and preparation of Department of Insurance filings for all existing and new Individual products.
  • Updates and development of all group rating factors, such as administrative retention allowances, trend projections, completion factors, deductible tables, rating manuals, etc.
  • Development and maintenance of all capitation rates.
  • May be responsible for the development of financial modeling and reporting for budgetary, strategic planning, and rating purposes.
  • May be responsible for the estimation of corporate unpaid claims liabilities.
  • Development of extensive, complex programs for the personal computer to ensure accurate and timely completion of tasks.
  • Coordination of all system changes, upgrades, and CSR modifications for the Actuarial department reporting.
• Participates in the development and review of long-range financial plans and policies.
• Coordinates the activities of the Actuarial Services department with other divisions on interrelated matters.
• May include maintenance of relationships with other Blue Cross and Blue Shield plans and with other agencies in the field of health care economics or prepayment and with the Blue Cross and Blue Shield Association on actuarial activities and issues.
• Participates in the development of new products or modifications to existing products.
• May include working with EDS, Information Services, and other personnel and utilizes internal programming capabilities toward the design, development and maintenance of the actuarial and underwriting data systems.
• Comply with BCBSAZ Computer Responsibility Agreement.  Employees with Internet access are required to comply with the Internet Policies Agreement.
• Apply appropriate security and privacy measures to all tasks.

Competencies

REQUIRED COMPETENCIES

Required Job Skills

• N/A

Required Professional Competencies

• Comply with BCBSAZ Computer Responsibility Agreement.  Employees with Internet access are required to comply with the Internet Policies Agreement.
• Apply appropriate security and privacy measures to all tasks.

Required Leadership Experience and Competencies

• Skill in oral and written communications
• Ability to establish and maintain effective relationships with others. 
• Strong leadership skills to manage and develop the Actuarial Services team.

PREFERRED COMPETENCIES

Preferred Job Skills

• N/A

Preferred Professional Competencies

• N/A

Preferred Leadership Experience and Competencies

• N/A

Our Commitment

AZ Blue 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.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.