Independence Blue Cross · 15 hours ago
VP & Chief Actuary
Philadelphia, Pennsylvania
Full-time
Hybrid
Director/Executive
15+ years expIndependence Blue Cross is a leading health insurer, and they are seeking a VP, Chief Actuary to lead a high-performing actuarial team. This role involves overseeing all actuarial functions, ensuring compliance and financial sustainability, while driving innovation and market competitiveness.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Direct and oversee pricing activity and rate filings for Commercial and Medicare market segments including the establishment of pricing and product strategies, formulas and tools for use by the Sales and Underwriting teams
Oversee the Pharmacy Underwriting team collaborating closely with sales, and pharmacy teams
Partner with the P&L, Sales and other leadership on the achievement of growth and profitability goals
Provide regular progress updates to the CFO, Segment leaders and other executives
Oversee evaluation of claim cost trends and establish medical cost assumptions for use in pricing and forecasting
Support provider contracting and related value-based contracting initiatives to position the enterprise competitively and achieve medical cost management targets
Develop and continue to enhance consistent ways to analyze drivers of cost trends and measure the impact of programs. Explain differences between forecasts and actual results for both medical and pharmacy spend. These methods should support health value optimization (HVO) efforts, ensuring they fit in with other medical cost initiatives and self-funded client strategies
Provide oversight of pharmacy economics: drug trend forecasting, specialty pipeline modeling, PBM performance, and value-based pharmacy arrangements
Establish methodologies and processes to accurately estimate claim reserve liabilities for all products and lines
Serve as or oversight of the Appointed Actuary, providing actuarial opinions for required regulatory filings
Support internal/external auditors, insurance departments, Finance and others in validating and documenting reserves or other actuarial interrogatories
Support the development of premium, revenue and claim cost estimates for the annual operating plan, mid-year forecast updates and long-term strategic planning, partnering with FP&A and providing strategic insight on projections and variance evaluation
Ensure regulatory compliance and analytics across all segments with technical leadership where appropriate for submissions and inquiry responses
Modernize actuarial modeling capabilities (predictive analytics, machine learning, actuarial automation) partnering with Business Technology Solutions and Informatics on cloud enablement and model lifecycle management
Establish governance standards for actuarial data quality and model documentation, ensuring compliance with internal controls, audit and regulatory expectations
Provide actuarial leadership for organic/inorganic growth and strategic provider partnerships (e.g. Tandigm), conducting due diligence and financial impact modeling
Champion professional development, mentoring, training and succession planning including sponsoring the actuarial student program and rotations
Uphold high ethical standards and foster a culture of accountability, collaboration and innovation
Qualification
Required
Bachelor's degree in Mathematics, Actuarial Science and/or Risk Management
Fellow of the Society of Actuaries (FSA), Member of the American Academy of Actuaries (MAAA)
Eligibility to serve as Appointed Actuary under applicable state requirements
15+ years of progressively responsible Actuarial experience
10+ years management and leadership experience within Actuarial functions, including leading multi-disciplinary teams
Strong health insurance background; knowledge of health care delivery systems a plus
Working knowledge of health insurance regulatory requirements, the Affordable Care Act, and accounting principles are a plus
Excellent verbal and written communication skills with strong executive presence and credibility with executive leadership and the Board
Demonstrated mastery across commercial and Medicare Advantage pricing, filings and revenue mechanics
Proven experience leading claim reserving and deep familiarity with NAIC and state DOI expectations
Advanced proficiency in actuarial modeling and analytics with experience in pharmacy economics including Part D, commercial PBM arrangements, and specialty trend dynamics
Strategic thinking with the ability to translate complex actuarial insights into actionable executive decisions
Talent engagement, development and succession planning for large teams with a small population of full remote resources
A highly ethical and trustworthy leader. A leadership style based on relationship and team building, trust, influence, credibility and service, together with a willingness to mentor, develop and educate
Cross functional influence with internal partners in Finance, Underwriting, Sales, Clinical, Provider Contracting, Operations, IT and Legal
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
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