Mgr, Actuary Medicare Advantage Bid ID-11861

December 18, 2024

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.

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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.

Disclaimer:

This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

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:

ASA required

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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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

DISCLAIMER

Other Jobs You May Be Interested In

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

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