CareFirst Careers

Actuary

Resp & Qualifications

SUMMARY:

This position will lead the pricing and actuarial analytical efforts related to multiple lines of business included Medicare Supplemental, FEHBP HMO, Student Health, and Specialty products including dental and vision.  This position will also be responsible for leading certain compliance processes within the Actuarial department.

ESSENTIAL DUTIES AND RESPONSIBILITIES may include, but are not limited to, the following:

Rate Filings

Responsible for leading the pricing of multiple lines of business including Medicare Supplemental, FEHBP HMO, Student Health Plans and Specialty products including dental and vision.  This will involve working with staff and senior management to prepare rate change proposals and working with the applicable regulators to obtain approvals for these proposals.  This position will also be the key point of contact within the Actuarial department related to all Specialty product activities.

Specialty Product Analysis Support

Responsible for leading all actuarial analysis related to specialty product new plan development and existing plan maintenance.  This would involve working with Actuarial staff as well as other key internal stakeholders (Marketing, Underwriting, Operations, etc.) to effectively execute the corporate strategy as related to the specialty product portfolio.  This position will also be responsible for leading efforts to expand pharmacy analytics capabilities within the Actuarial department.

Actuarial Compliance Support

Responsible for leading all actuarial efforts related to compliance activities including but not limited to mental health parity testing and Medicare Part D creditable coverage testing.

 

Management

Hiring, recruiting and developing a purpose-driven, growing team with balanced, optimal work distribution, visibility and SOA exam success.

 

QUALIFICATION REQUIREMENTS:

  • Bachelor’s degree in a related field with 8 years of progressively responsible pricing and actuarial experience in health care, and a minimum of 5 years of management experience and a Fellow in the Society of Actuaries (FSA).
  • Individual must be extremely knowledgeable of risk evaluation and rating techniques and thoroughly familiar with a variety of health insurance products including HMO’s, Indemnity, POS/Opt-Out, Consumer-Driven and other products.  It is essential that the individual possess highly developed analytical skills and excellent interpersonal and communication skills, both written and oral, to the point where complex actuarial and underwriting issues are effectively conveyed to a diverse audience. Must have computing skills with both PC-based and mainframe applications. The position requires strong leadership skills, as well as the ability to effectively negotiate and sell company rating policy.
  • Must demonstrate resilience and effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

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Department

Actuarial Group Pricing

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Closing Date

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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