Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware
Job Summary:
This role will lead the newly created Medicare Transform team and will lead 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.
Responsibilities:
- Lead actuarial pricing for the Medicare Advantage bid process, fostering relationships and collaborating with other stakeholders and matrix partners.
- Develop 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).
- Explain and communicate variances and drivers of forecasts to senior leadership.
- 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.
Education/Experience:
- Bachelors degree required, preferably within Mathematics, Statistics, Actuarial Sciences or a related field.
- Requires 7+ years of Actuarial and/or statistics experience and attainment of Associate level in the Society of Actuaries (ASA).
- Prefers supervisory experience.
- Requires 5 + years of experience in Actuarial bid pricing.
Additional licensing, certifications, registrations:
Knowledge:
- Requires expert knowledge of Excel.
- Requires advanced proficiency with SAS.
- Requires expert knowledge of Medicare Advantage bid regulations and bid instructions.
- Requires in depth knowledge of the Medicare Advantage industry.
Skills and Abilities:
- Requires excellent oral and written communication skills.
- Requires strong analytical thinking.
- Requires strong mathematical skill and statistical analysis abilities.
- Requires good judgment and problem-solving skills.
- Requires strong managerial skills.
- Requires strong leadership skills.
Salary Range:
$121,800 - $166,215
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
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