Resp & Qualifications
PURPOSE: The Manager is responsible for leading a team of highly talented and motivated individuals that develops innovative and complex data solutions and applications to support actuarial analytics specializing in medical economics. With a critical eye towards data integrity and a deep understanding of claim and provider data, the Manager will partner with actuaries to produce trend analytics tools and dashboards, support Medicare Advantage/Medicaid reporting and assist with ad hoc reporting and analysis. Additionally, the Manager will partner with actuaries to support efforts related to network and provider contracting optimization including analyzing the financial impact derived from innovative partnerships with providers through value-based contracting and affordable care organization (ACOs) arrangements.
As an integral part of the Actuarial Systems management team, the Manager will be responsible for researching and integrating new and innovative technologies into Actuarial’s data environment to enhance the data analytics and reporting functions with the primary focus to improve data accessibility to actuarial analysts.
This is a fast-paced, collaborative and iterative environment requiring quick learning, agility and flexibility.
Paramount to being successful is the ability of the Manager to cultivate a synergistic relationship between the actuaries, the systems team and the data to develop critical insights into improving the actuaries’ understanding of its members and associated risk management endeavors.
Under the general supervision of the Director, Actuarial Systems, the incumbent’s accountabilities include, but are not limited to, the following:
Manages the leadership and planning to ensure resources are utilized appropriately to meet the Division’s strategic objectives. Delegates responsibility and authority to appropriate staff within the team.
The manager evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policy. Must also motivate, coach, counsel and develop team members within the context of the corporate policies and manages the team’s budget. Ensures that staff has appropriate tools and training.
Communicates with Directors, Executives and other Corporate management to plan and implement Division Strategic Objectives. The manager also communicates with other departments, auditors, and Blue Cross Blue Shield Association (BCBSA) to coordinate and implement system projects and enhancements. Attend management sessions to ensure that the team’s operation and long-range goals are coordinated within the larger framework of department, divisional and corporate initiatives.
Ensures the successful completion of projects by monitoring the projects and managing competing priorities to support the Division objectives on time, within budget.
Researches technical, business and theoretical developments in the field to ensure that customers are receiving the most effective support to meet their business objectives.
Required: This position requires a bachelor’s degree with a minimum of eight years of IT or business/systems background, OR equivalent work experience. Experience in full life cycle project management and leadership. Proven ability to budget, organize and manage teams. Assist with project management on multiple projects. Must be able to teach, develop, and motivate associates.
Abilities/Skills: Additionally, this position requires exceptional analytical skills as well as strong programming and logic skills. Understanding of database modeling and development along with query design and report writing is important. Knowledge of actuarial methods for analyzing financial information regarding claims reserves and claim trends for cost and utilization benefits is needed to be effective in this position. Previous knowledge of financial reporting for GAAP and Statutory reporting requirements are integral to the preparation of financial information. The ability to work independently and in a team is necessary, as well as the willingness to work overtime when needed and to multi-task in a fast-paced environment. Strong oral and written communication abilities are essential as are excellent interpersonal skills. Strong management skills required.
Must be able to 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.
Preferred: Broad knowledge of CareFirst organization and operations. Experience with both mainframe and client/server technology including database and application development Experience with other tools specific to the area managed including SQL Server Management Studio (SSMS) and SQL Server Integration Services (SSIS). Extensive Personal Computer (PC) skills including Microsoft Office software such as Word, EXCEL, MS Project, MS Access and PowerPoint 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.
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
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.
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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