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Director Actuarial Services

MEDICA HEALTH PLANS

MADISON, WIJobSeen todaySeen in employer's feed today

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At a glance

Compensation
No compensation found
Location
MADISON, WI
Work Authorization
Not specified

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Job overview

Medica is a nonprofit health plan serving communities across several states. Its actuarial department analyzes financial experience, quantifies risk, and projects medical expenses, with the goal of providing reliable insight into product financial performance and medical trends. The Director Actuarial Services role oversees actuarial analysis and works with segment leadership on product design, risk, pricing, and financial performance.

Skills & qualifications

RequiredNice to have

Skills

Actuarial AnalysisFinancial Risk AnalysisFinancial ForecastingProduct PricingRisk AdjustmentSensitivity TestingUtilization AnalysisProvider Data Analysis

Full job description

JOB REQUIREMENTS: Description Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Actuaries use technical knowledge and business acumen to analyze financial experience, quantify financial risk, and project future medical expenses. They are expected to adhere to the highest levels of ethics, professionalism, and standards of practice, as defined both internally and by the American Academy of Actuaries. The goal of the actuarial department is to be Medica's source of truth for product financial performance and medical trend. At all levels, this requires a commitment to producing complete, timely, and accurate actuarial analysis. For more senior positions, this also requires the ability and willingness to work with the segments and help them meet their strategic goals and objectives. Performs other duties as assigned. Key Accountabilities Conduct Experience Studies Is familiar with the data and technology tools available to Medica's actuarial department Oversees the creation, development, and consistent production of accurate and timely actuarial information, reports, and exhibits Reviews the work of analysts and other credentialed actuaries for reasonability, appropriateness, and relevance Quantify Risk Works closely with segment leadership on product design, especially in areas of risk selection and induced utilization Directs the work of analysts and/or consultants regarding key variables to stress during sensitivity testing Communicates key variance in actual/expected financial performance to Medica and segment leadership Incorporates the impact of risk adjustment into financial projections and performance analysis Provide Context Works with Medica and segment leadership to create appropriate financial targets for pricing and product performance Uses appropriate benchmarks when analyzing utilization and provider data Provides the organization with appropriate value for actual/expected analysis, including intra-year targets for use by Medica leadership, segments, and corporate finance Forecast Financial Performance Owns the actuarial component of all product pricing. Works with segment leadership to incorporate actuarial, risk, competitive information, and aligning corporate and segment priorities around profit and... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/40E84BE2D9C849DE

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