Resp & Qualifications
PURPOSE:
To seek a highly qualified individual, progressing toward ASA/FSA designation, to support the new and growing Medicare Advantage line of business.
PRINCIPLE ACCOUNTABILITIES:
Under the general supervision of the Medicare Actuary, the incumbent’s accountabilities include but are not limited to the following:
Annual Medicare Bidding Actuarial Support: Perform analytics to support the Medicare bidding process. Work with internal and external partners for successful bid submission. Provide bid information needed by other functional area in a timely manner.
Monthly financial analysis, Part D & risk score accrual and Data Reconciliation: Analyze monthly financial data to identify data issues and cost drivers. Estimate Part D and risk score accruals by updating year-end projections based on emerging data. Assist with reconciliation between CMS and internal data.
Experience study: Conduct experience study on a regular and ad hoc basis to help informing business decisions.
Medicare group pricing and Part D Creditable Coverage Testing: Review and update the Medicare group pricing model. Perform Creditable Coverage Testing for group Part D plans.
QUALIFICATION REQUIREMENTS:
Required: The candidate must have a Bachelor’s Degree in a related field with at least 4 years of experience in insurance, statistical or finance related area preferred.
The candidate must have a strong mathematics/financial background. Advanced computing skills with both PC based (Microsoft Excel, Access) and Mainframe applications.
Must demonstrate flexibility, innovation, and problem-solving skills and resourcefulness. Ability to express technical and actuarial analysis in a clear, concise manner in both oral and written form. Must be able to prepare ad hoc analysis, experience studies and reports. Plan and prioritize work. Negotiating and consulting skills. Work in a team environment.
Passage of two exams are preferred.
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.
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
