Manager, Actuary

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!

Description

Job Summary
  • Overall responsibility and accountability for reviewing staff work product related to reserving, CMS/ACA related risk adjustment processes, pricing, forecasting, trend setting, and/or network development and alternative provider payment models.
  • Responsible for developing and managing experience tracking reports, comparisons to Plan, tracking and quantifying variances and shares insights with the business unit and management Ensures timely and accurate delivery of all work products associated with their job responsibilities.
  • Ensures team follows existing work flow procedures or policies and/or validates or developments new procedures and policies.
  • Responsible for understanding current and emerging regulatory and competitive developments, facilitating communication of these developments, and ensuring processes and procedures are consistent with changing regulations.
  • May lead special projects/ committees/task forces. Other duties as assigned. Plans and establishes operational objectives for team and/or job area with measurable contribution towards achievement of results for the department.
  • Assigns tasks to team to achieve operational targets, service standards, etc. Focuses on short to mid-term operational plans (e.g., 1-2 years). Responsible for making improvements and modifications to operating policies to enhance performance of the department.
  • Problems and issues faced are difficult and may require understanding of broader set of issues. May involve consideration of multiple issues, job areas or specialties and are typically solved through drawing from prior experience and analysis of issues.
  • Communicates with parties within and outside of the operational team, which may include external customers or vendors. Influences decisions which are usually more project and operationally oriented.
  • Explains policies, practices and procedures of the job area/department to others within the organization. May work to justify and gain cooperation of other parties on practices, policies and procedures.
  • Supervises a team consisting of professionals and /or supervisors. Leads, directs and reviews the work of team members to accomplish operational plans and results within schedule and budget. Performs annual performance review and periodic performance check-ins with team members.
  • Sets annual goals of team members and has primary responsibility of coaching team members and facilitating their career development.
  • Provides primary input to hiring, firing, promotion, performance and rewards decisions for direct reports with including the hiring or firing of employees, in accordance with organization guidelines.




Qualifications

Knowledge ad Experience
  • Bachelor's degree in actuarial science, mathematics, statistics, computer science or related field and 7 years prior relevant job including 3 years experience of operating in a team leader role.
  • Typically, has at least an an Associate of the Society of Actuaries(ASA) Has advanced knowledge, skills and expertise of job area including technical or functional expertise, business acumen, financial analysis skills, and risk management.
  • Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation.




Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
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External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.EEO Policy