JOB SUMMARY
The Chief Actuary is responsible for the daily operations associated with Highmark, Inc. Actuarial function and will lead the organization's product pricing strategy. He/she will provide overall direction relative to the development, application and consistent administration of actuarial principles and statistical techniques to ensure sound financials.
ESSENTIAL RESPONSIBILITIES
Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; also will have budgetary responsibility and authority.
Provides overall direction relative to the review and evaluation of government programs, commercial markets and diversified businesses (dental, pharmacy and stop loss), product pricing strategy and policies. Responsible for pricing on all products, including but not limited to building sound pricing models, working with internal staff to arrive at sound products and strategies, and working with the regulatory authorities to approve products/pricing.
Devises, collects, maintains, and reports financial and statistical information required to monitor cost and utilization trends for all lines of business and benefits in order to assure accuracy of the factors used in current rating/financial arrangements.
Responsible for tracking and projecting trend rates for every line of business. This includes monthly tracking, finding causes, and providing guidance for senior management, pricing, and budgeting processes.
Responsible for all work related to claim reserves, including but not limited to monthly derivation of required claim reserves, determining best methods for predicting required claim reserves, providing an Actuarial Statement of Opinion for the claim reserves, and working with auditors to arrive at mutually-acceptable conclusions.
Ensures the calculation of the unpaid claims liability, the reporting of underwriting/financial results by line of business and product, and the reporting of contract inventory for the monthly financial statement.
Ensures a financial forecasting system which generates accurate projections relative to income, claims, administrative expenses, underwriting gains/losses, investment income, by line of business, with the ability to explain variances to senior management.
Works cross-functionally with the Provider Network Management and Underwriting departments to ensure that business knowledge gathered from our customers and providers is incorporated into decision-making process.
Acts as a visible leader impacting strategic initiatives in the form of ideas, market research, financial modeling, business plan development, and implementation. This can include non-traditional areas such as: medical management effectiveness, vendor effectiveness, and government-related programs.
Responsible for driving the actuarial talent development and leadership development strategy with the goal of creating a proactive talent development strategy to administer a process which focuses on building bench strength to meet current and future talent needs. Provides executive oversight for the Actuarial Student Program.
Serves as liaison with insurance regulators, external auditors, and Board of Directors with regard to pricing, loss reserving or other actuarial matters. Represents Highmark in meetings with significant customers to maintain the company’s credibility and gain their confidence.
Other duties as assigned or requested.
EDUCATION
Required
Bachelor's Degree in Mathematics, Actuarial Science or a related field
Substitutions
6 years of experience in related role
Preferred
Master's Degree in Business Administration
EXPERIENCE
Required
15 years of progressive industry experience in actuarial areas
To include
10 years in a leadership role
Preferred
10 years of Healthcare actuarial experience
7 years with Financial Analysis and Planning
3 years in Underwriting
LICENSES or CERTIFICATIONS
Required
FSA (Fellow of the Society of Actuaries)
Preferred
CPA (Certified Public Accountant)
SKILLS
Inspire others through vision and action
Embrace, drive and shape change within and outside of the department
Communicate with impact, clarity and authenticity at all levels of the business, internally and externally
Collaborate with other parts of the organization to achieve shared success
Influencing other through relationships and partnerships, not through title and hierarchy
Critical and strategic thinking, able to see the big picture, create plans and solve problems for the enterprise
Languages (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL AND WORKING CONDITIONS
Position Type
Office Based
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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