Job Description Summary
The Executive Director FEP Actuarial Services serves as the primary actuarial representative and is responsible for providing and directing actuarial services with respect to the FEHBP/FEDVIP while also supporting the Chief Actuary in providing services for the Association's strategic policy; licensing and monitoring programs; healthcare system and delivery programs; and other BCBSA programs and initiatives. Contributes to the effectiveness of the programs by providing expert technical advice, balanced by consideration of general business, state/federal insurance regulation, BCBSA licensure requirements and the competitive environment. Enhances the reputation of BCBSA and Actuarial Services within Plans, BCBSA, industry and other relevant stakeholders through thought leadership and technical support. These services are provided to Licensee senior management and Boards of Directors, BCBSA senior management and governance, and external organizations.
Responsibilities include but are not limited to:
- Oversee the actuarial services provided in support of BCBSA's Federal Employee Program and FEDVIP to ensure the business objectives and the needs and expectations of FEP's management and governance, and OPM are met.
- Rate development, including trend analysis and forecasting, for FEP and FEDVIP products and any other related products, including negotiation with OPM.
- Development and management of multi-year forecast models for FEP and FEDVIP and related programs.
- Product development activities for FEP and FEDVIP, to include short-term and long-term development activities.
- Competitive analysis of the FEHBP and FEDVIP and related markets.
- Development and management of IBNR models and financial reporting functions and requirements
- Strategic planning activities for FEP and FEDVIP and related programs
- Provide and oversee actuarial technical expertise in the development of BCBSA strategic policy and advocacy positions. Represent and advocate these positions to external organizations (e.g., regulators, governmental agencies, and other related organizations) and to Licensee and BCBSA senior management in the interpretation and implementation of actuarial, underwriting and solvency regulation/legislation, policies, practices, and reporting requirements.
- Develop, recommend and implement state-of-the-art performance measures and monitoring approaches/tools and licensure programs. Provide and oversee actuarial analysis of Licensee performance by:
- Participating on multi-disciplinary teams which monitor Licensees' performance and compliance.
- Developing consultative relationships with Licensee senior management, including CFOs and Chief Actuaries, and technical staff.
- Developing a thorough understanding of a Licensee's current and future viability, product portfolio, and provider contracting strategy and competitive and financial position.
- Converting the data collected and analysis performed into information used to advise:
- Plan management and Board of Directors on appropriate actions to improve performance and/or maintain compliance with BCBSA license agreements; and
- BCBSA senior management and governance on appropriate monitoring and licensure actions, including license termination.
- Provide and oversee actuarial technical expertise in the development of incurred but not reported claims estimates, premium equivalents, benefit design changes, and other functions as requested, to support BCBSA's employee benefit programs.
- Oversee the development of strategies to facilitate System-wide actuarial/underwriting education, training and best practice sharing.
- Provide and oversee actuarial technical expertise, as appropriate, to support BCBSA ad hoc strategic and operational initiatives.
- Develop and maintain a strong network of Plan actuaries and communications to facilitate information and best practice sharing, and networking across Plans and with BCBSA.
Required Education, Certifications and Experience
- Bachelor's degree in mathematics, accounting, economics or related field.
- Associate of the Society of Actuaries (ASA)• Membership in the American Academy of Actuaries (MAAA).
- Minimum of 15 years of progressive actuarial experience in the health insurance/managed care industry (operational and/or consulting experience) is required.
- Minimum 7 years of supervisory experience including coaching and developing actuaries.
- Experience evaluating corporate actuarial, underwriting, provider reimbursement and marketing strategies and processes, as well as competitive position• Experience developing state-of-the art performance measurement tools and monitoring approaches and tools.
- Experience advising corporate management on improving profitability and competitive position.
- Excellent oral and written communication skills.
- PC proficiency (Microsoft Office, actuarial software).
- Customer-oriented, self-starter, goal directed, high-energy individual who is a creative, problem solver.
- Ability to establish credibility and consultative relationships with a broad array of executives across all disciplines, insurance regulators, Boards of Directors, and other actuaries.
Preferred Education, Certifications and Experience
- Fellow of the Society of Actuaries (FSA).
- Experience working in or consulting with Blue Cross and Blue Shield Plans desired.
- Operating in a team environment and establishing a leadership and teaching role with highly trained, technical staff with a broad array of expertise and backgrounds.
- Experience working with individual choice health insurance programs (FEHBP, FEDVIP, public or private exchanges)
People Management - Yes