Blue Cross Blue Shield of Arizona
Receive alerts when this company posts new jobs.
Actuarial Analyst- Forecasting and Reserves
at Blue Cross Blue Shield of Arizona
Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Purpose of the Job
Performs advanced analytics to facilitate fact-based decision-making regarding financial results, strategic planning, and corporate financial soundness.
Essential Job Functions & Responsibilities
• Under close supervision, complete financial forecast scenario modeling to evaluate and ensure corporate financial health.
• Propose and perform profitability analysis which aids in identifying necessary strategic action.
• Analyze and monitor monthly financial results, sources of gain and variances to plan.
• Design and prepare models to establish the amount of capital that is adequate to withstand normal volatility and a range of probable adverse events on a book of business.
• Calculate and analyze the risk-based capital required by the NAIC; create monthly claims liability estimates for at-risk claims expense, for review and certification by Chief Actuary.
• Analyze internal and external issues impacting claims payments/processing and initiate analyses on additional items with focus on establishing an adequate claims reserve level.
• Work with finance and tax departments on regulatory filings including quarterly and annual health statement filings and medical loss ratio reporting.
• Interpret, communicate, and present results of analyses to directors, vice presidents and executive vice president.
• Determine the necessity and amount of a premium deficiency reserve based on projections of future revenue and benefits to ensure solvency requirements are met.
• Work with underwriting to determine appropriate factors for group pricing: stop-loss, area, industry, and benefit factors,
• Identify areas of gain by pricing segment, i.e., area, age/gender, stop-loss, funding arrangement by comparing experience to expected projections, determining differences, and recommending corrective actions.
• Work with underwriting and finance departments to determine adequate administrative expense rates for large groups, considering the competitive environment and profitability impact. Ascertain the appropriate allocation of administrative expense by line of business for use in pricing and profitability projections.
• Work with sales and marketing in development and design of benefits for all existing and new products.
• Under general supervision, complete financial forecast scenario modeling to evaluate and ensure corporate financial health
• Display initiative in research beyond the specific assignment
• Pursue expansion of current knowledge and skills.
• Meaningfully contribute to the area’s workload, considering volume and complexity.
• Provide self- and peer-review of level 1.
• Report to a supervisor or manager who provides minimal supervisory instructions, limited project management, and minimal or limited review of results, beyond pre-release peer review.
• Along with research, create analyses and recommendations that will allow BCBSAZ to meet its goals
• Plan and lead complex projects from inception to completion. Includes working independently on creating timelines, working with other areas to define deliverables, monitoring progress, implementing the project and resolving/monitoring post-implementation issues.
• Communicate (both verbally and in writing) and interprets results, recommendations and abstract concepts to internal and external customers. Anticipate and addresses possible customer questions and concerns.
• Incorporate strategic planning in all areas of responsibility.
• Train and mentor other analysts and provide peer review.
• Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
• Perform all other duties as assigned.
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Skill / Requirements
1. Required Work Experience
• 1 year of experience in an actuarial field – may be acquired through coursework or internship (Level 1)
• 2 years of experience in an actuarial field (Levels 2 – 3)
2. Required Education
• Bachelor's Degree in business, mathematics, statistics, or related field of study (Applies to All Levels)
3. Required Licenses
4. Required Certifications
1. Preferred Work Experience
• 5 years of experience working for a healthcare organization / health insurer (Applies to All Levels)
• 5 years of experience in an actuarial or healthcare economics field (Applies to All Levels)
2. Preferred Education
• Master’s Degree in business, mathematics, statistics, or related field of study (Applies to All Levels)
3. Preferred Licenses
4. Preferred Certifications
• Associate, Society of Actuaries (ASA) (Applies to All Levels)
• Member of the American Academy of Actuaries (MAAA) (Applies to All Levels)
1. Required Job Skills (Applies to All Levels)
• Intermediate skill in use of office equipment, including copiers, fax machines, scanners and telephones
• Intermediate PC proficiency
• Intermediate proficiency in database, presentation, and word processing software
• Expert proficiency in spreadsheet software(Applies to Levels 2 – 3)
• Basic proficiency in data warehouse querying tools (Applies to Levels 2 – 3)
• Advanced skill in mathematics and statistics
2. Required Professional Competencies (Applies to All Levels)
• Broad understanding of health insurance terms and concepts; knowledge of benefit design and rating techniques
• Analytical knowledge necessary to generate reports, actuarial analyses, and mathematical models based on available data and then make sound decisions based on reported data
• Ability to solve problems independently and draw accurate conclusions from limited data using basic mathematical modeling and actuarial techniques.
• Ability to deal with ambiguity and make recommendations with less than complete or conflicting information while maintaining appropriate time management.
• Ability to maintain confidentiality and privacy
• Ability to communicate effectively, both orally and in writing, to all levels in all departments.
• Ability to summarize technical information to a non-technical audience.
• Ability to build and maintain productive working relationships with others.
3. Required Leadership Experience and Competencies (Applies to All Levels)
1. Preferred Job Skills (Applies to All Levels)
• Advanced skill in use of office equipment, including copiers, fax machines, scanner and telephones
• Advanced PC proficiency
• Advanced proficiency in presentation, database and word processing software
• Intermediate proficiency with data warehouses and query tools / design
2. Preferred Professional Competencies (Applies to All Levels)
• Knowledge of funding arrangements and their ratings
• Project management skill needed to create timelines, track deliverables and progress, resolve issues, and communicate project status
3. Preferred Leadership Experience and Competencies (Applies to All Levels)