Sr Mgr Reserving, Forecasting
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.
For Internal Use Only*
Grade Level- Level II, Technical 36
Purpose of the Job
Manages pricing and forecasting competitive premium levels for group products.
Essential Job Functions & Responsibilities
* Monitor and determine necessary adjustments to the monthly financial forecasts for all lines of business. Develop underlying factors for forecasting including necessary trend and seasonality. Interpret emerging financial results versus the financial Plan and forecasts. Explain variances with financial to Executive management
* In coordination with the Manager of Pricing and Forecasting, ensure the development of the Financial Plan is consistent with pricing strategy.
* In coordination with the General Managers of the business segments, develop Financial Plans for their segment, incorporating corporate profit and membership targets, develop monthly financial forecasts and compare to the Financial Plan. Work with GM’s to help explain variances with the Financial Plan in the monthly Close meetings.
* Propose and perform financial forecast scenario modeling to evaluate and ensure corporate financial health.
* Identify ways to mitigate or correct deterioration in the financial performance of the various lines of business and work with the General Managers of the business segments to develop corrective strategies
* Design and prepare models to establish the amount of capital that is adequate to withstand normal volatility and a range of probable adverse events on a book of business.
* Calculate monthly claims liability estimates for all business segments, for review and certification by Chief Actuary.
* Analyze internal and external issues impacting claims payments/processing and initiate analyses as needed to allow for the establishment of an adequate claims reserve level.
* Work with finance and tax departments on regulatory filings including quarterly and annual health statement filings and PPACA MLR reporting.
* Determine the necessity and amount of a premium deficiency reserve based on projections of future revenue and benefits to ensure solvency requirements are met.
* Understand, evaluate and implement protocols and procedures to address needs imposed under Federal and State legislation, e.g., the Affordable Care Act. This includes items such as risk Adjustment and the PPACA MLR
* 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.
* Oversee day-to-day departmental administration by coaching and motivating staff and departmental personnel to make maximum use of experience and skills.
* Maintain effective working relationships to ensure teamwork in achieving corporate goals.
* 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
* Promotion with in Grades is based on performance compared to the Manager Grade Differentiation - Leadership competencies. Primary competencies used in evaluation
* Influence/Champion Changed
* Dealing with Ambiguity/Resilience
* Effective Communication
* Strategic Agility
* Motivating Others
* Delegation/Priority Setting
1. Required Work Experience
* 3 years of actuarial experience, including development of rate schedules, funding arrangements, and payment methodologies
2. Required Education
* Bachelor’s degree in mathematics, statistics, or related field
3. Required Licenses
4. Required Certifications
1. Preferred Work Experience
* 5 years of management experience
* 7 years of actuarial experience, including development of claims reserves, forecasting and modeling techniques and Annual statement preparation
2. Preferred Education
3. Preferred Licenses
4. Preferred Certifications
* Associate Actuary, Society of Actuaries
1. Required Job Skills
* Intermediate PC proficiency.
* Intermediate skill in databases and spreadsheets
2. Required Professional Competencies
* Superior analytical skills
* Ability to define problems, oversee collection of data, establish facts, and draw valid conclusions
* Technical ability to resolve complex business and actuarial issues.
* Management skills in an operationally changing environment, with drive for results and success based on planned objectives.
* Ability to deal with the unpredictability of the insurance business and minimize the variance between predicted and actual outcomes.
* Strong customer service skills.
* Interpersonal skills that allow for harmonious relationships with providers, members and coworkers.
* Recognize strategic opportunities and use data to make timely and sound decisions.
* Flexibility and willingness to adjust to shifting demands/priorities.
3. Required Leadership Experience and Competencies
* High standard of performance while pursuing aggressive goals
* Principled leadership and sound business ethics
1. Preferred Job Skills
2. Preferred Professional Competencies
3. Preferred Leadership Experience and Competencies
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.
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.
Imagine doing life-changing work and helping more than one million Arizonans live healthier and longer lives. That’s the kind of satisfaction you’ll find when you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming healthcare for more than 80 years. Explore what's possible with a career at Blue Cross® BlueShield® of Arizona