DIRECTOR RESERVING in Boston, MA at Beacon Health Options

Date Posted: 7/5/2018

Job Snapshot

Job Description

General Summary    

The VP of Reserving reports directly to the SVP, Chief Actuary and has key responsibilities for maintenance of reserves, adequacy of medical cost accruals for all of Beacon Health’s risk business.  Managing a team of 5-7 employees the position works directly with the controller to ensure appropriate and accurate monthly accruals, adequate provisions for PDRs and risk share calculations. Other responsibilities include managing actuarial aspects of financial audits and reporting on financial results to key risk clients. This position continually interacts with regional and senior executive leadership. They are a key point of contact for the regional CFO and regional president within the actuarial area. The successful candidate will be a demonstrator leader with the agility to adapt to change and innovate

Duties and Responsibilities

  • Lead the monthly reserving process for timely close including ensuring accurate ledger accruals for all liabilities  
  • Monitor experience and develop expert knowledge of all risk accounts. This encompasses all lines of business including but not limited to Large commercial. QHPs, Medicare and Medicaid
  • Develops close working relationships with leaders of claims, clinical, benefits administration, local operational centers to ensure a continuous understanding of changes impacting claims completion 
  • Keeps abreast of any significant operational issues,  alerts leadership and Chief Actuary of any concerning risks and helps quantify impact of significant operational issues
  • Maintains, streamlines and improves capabilities  and flexibility of reserving models
  • Leads innovation to improve timeliness of close process and ensures effective presentation of results in terms which are audience appropriate
  • Works closely with other leaders such as underwriting and health care economics contributing to accuracy of pricing and reporting.
  • Establishes appropriate margin, PDRs and LAE as well as maintenance of relevant P&Ps
  • Develops relationships with other areas and directs staff to use coding skills to quickly investigate unusual observations, figure out innovative approaches to quantifying liabilities
  • Works with Heath Care economics to develop benchmarks and identify trend drivers, including appropriately identifying and reserving for impact of legislative changes 
  • Be able to react quickly to changes such as deployment of ACO models and report on risk sharing arrangements
  • Understand populations and cost drivers by level of care
  • Understand the financials for key accounts and be able to explain results drivers to regional CFOs and clients
  • Drives pricing strategy and negotiations with clients
  • Manages a team of 5-7 including managers and analysts while interacting closely with entire Actuarial, Underwriting and Health Care Economics team

Minimum Entry Level Qualifications


Education:    

Bachelor’s degree in a business, accounting, mathematical or science discipline preferred

      ASA designation required, FSA preferred. Must be CPD compliant.


 Licensures:    

ASA (FSA preferred), MAAA
 

 Years and Type of Relevant Work Experience:

  • A minimum of 10 years in reserving and experience in either pricing, medical economics or financial planning will be a plus. Also experience in working with external auditors preferred.
  • Significant degree of experience interacting with senior management, claims, clinical and some interaction with external clients preferred
  • At least 5 years of experience in managing teams
  • Excellent communication skills, proven ability to work with leaders, subordinates and peers.

TO APPLY

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

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