Managing Actuary - Risk Adjustment

Posted 13 Days Ago
Be an Early Applicant
Eagan, MN
115K-196K Annually
Senior level
Healthtech • Insurance
The Role
The Managing Actuary is responsible for conducting research and analysis related to risk adjustments, training the actuarial team, designing predictive models, and leading project initiatives. They will provide insights into Medicare, Medicaid, and ACA regulations while ensuring product and process development aligns with financial soundness.
Summary Generated by Built In

About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?

We are looking for a Managing Actuary to apply broad actuarial principles to develop solutions for risk adjustments, primarily in MedicareMedicaid and ACA. The Managing Actuary is responsible for guiding and motivating the actuarial team. This is a high visibility role that will directly impact our organization’s goals!  

A Day in the Life:

  • Research and Analysis: Conduct in-depth research, analysis, and interpretation of actuarial and statistical data specifically related to risk adjustments. Identify issues requiring investigation, determine affected areas, estimate impacts, and lead resolution efforts.

  • Issue Identification and Resolution: Identify and research issues related to Medicare risk adjustments, determine the areas affected, estimate the impact, and lead the resolution process.

  • Training and Supervision: Provide training and work direction to Analysts, ensuring they are well-versed in risk adjustment methodologies and practices.

  • Model Design: Collaborate with other departments to design mathematical models that predict the impact of proposed changes on risk adjustments.

  • Product and Process Development: Analyze claims, revenue, and other relevant data to suggest amendments or develop new products and processes that maintain product viability and financial soundness.

  • Project Leadership: Represent the division on corporate projects, potentially taking on leadership roles within these teams to ensure risk adjustment considerations are addressed.

  • Data Management: Independently manage the retrieval and analysis of data for multiple tasks or projects related to risk adjustments, with minimal management involvement. This may include directing other staff members.

Nice to Have:

  • Bachelor's degree.

  • Experience with risk adjustment heavily preferred.

  • Experience with Medicare

  • If you do not have Medicare experience, we are also looking for candidates with Medicaid and ACA experience.

Required Skills and Experiences:

  • 6+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

  • ASA or above.

  • Strong Delegation skills.

  • Strong oral and written communication skills.

  • Excellent PC skills.

  • Knowledge of data retrieval languages.

  • Knowledge of BCBSMs databases or industry knowledge.

Role DesignationHybrid

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely.  Onsite is full-time onsite.

Compensation and Benefits

$115,000.00 - $155,300.00 - $195,600.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

  • Medical, dental, and vision insurance

  • Life insurance

  • 401k

  • Paid Time Off (PTO)

  • Volunteer Paid Time Off (VPTO)

  • And more

To discover more about what we have to offer, please review our benefits page.

Make a Difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected].

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
 

Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Eagan, MN
3,267 Employees
On-site Workplace

What We Do

Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives. Chartered in 1933 as Minnesota’s first health plan, we’ve promoted wider, more economical and timely availability of health services for the people of Minnesota for 80+ years.

Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross® and Blue Shield® Association.

Similar Jobs

PwC Logo PwC

SAP Finance Product Costing Lead (must have Pharma and Life Sciences experience)

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote
Hybrid
18 Locations
364000 Employees
100K-232K Annually

Wipfli Logo Wipfli

Senior Manager/Director, Tax - High Net Worth

Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Remote
Hybrid
Minneapolis, MN, USA
3300 Employees
131K-197K Annually

Wipfli Logo Wipfli

Senior Accountant - Outsourced Accounting

Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Remote
Hybrid
Minneapolis, MN, USA
3300 Employees
66K-109K Annually

Wipfli Logo Wipfli

Tribal Senior Accountant - Audit

Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Remote
Hybrid
Minneapolis, MN, USA
3300 Employees
80K-109K Annually

Similar Companies Hiring

MassMutual India Thumbnail
Insurance • Information Technology • Fintech • Financial Services • Big Data
Hyderabad, Telangana
Cencora Thumbnail
Pharmaceutical • Logistics • Healthtech
Conshohocken, PA
46000 Employees
Stepful Thumbnail
Software • Healthtech • Edtech • Artificial Intelligence
New York, New York
60 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account