Lead Actuary Medicare Advantage

Horizon Blue Cross Blue Shield of New Jersey•Hopewell, NJ

About The Position

This role will support the actuarial bid pricing process for Horizon’s joint venture Medicare lines of business, in addition to providing detailed forecasts, conducting and tracking profitability analyses, and authoritatively communicating results and providing reporting to stakeholders and senior leadership.

Requirements

Bachelors degree, required preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university.
Requires 5+ years of experience in Medicare Advantage actuarial bid pricing.
Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) preferred.
Requires expert knowledge of Excel.
Requires advanced proficiency with SAS or SQL.
Requires expert knowledge of Medicare Advantage bid regulations and bid instructions.
Requires in depth knowledge of the Medicare Advantage industry.
Requires excellent oral and written communication skills.
Requires strong analytical thinking.
Requires strong mathematical skills and statistical analysis abilities.
Requires good judgment and problem solving skills.
Requires strong leadership skills.

Nice To Haves

Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) preferred.

Responsibilities

Support actuarial pricing for the Medicare Advantage bid process and forecasting, working in conjunction with department leadership.
Support developing a robust suite of internal tools for the bid process, member-level and cohort-level profitability analysis, and detailed forecasting.
Forecasting and profitability analysis.
Perform other ad-hoc analyses as requested (examples include assessing the impact of Star rating changes, benefit changes, or other changes).
Investigate and communicate variances and drivers of forecasts to department leaders.
Provide strategic thinking regarding the overall business strategy, incorporating product knowledge and broad Medicare Advantage landscape market dynamics.
Supervise and train junior actuaries as needed.