Actuarial Director, Health Economics – 2024-226-2367 in Boise, Idaho

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PacificSource is an equal opportunity employer. All qualified
applicants will receive consideration for employment without regard to
status as a protected veteran or a qualified individual with a
disability, or other protected status, such as race, religion, color,
national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the
people we hire and serve. We are committed to creating a diverse
environment and fostering a workplace in which individual differences
are appreciated, respected and responded to in ways that fully develop
and utilize each person’s talents and strengths.

Provide actuarial services in the area of health economics. Lead
organizational discipline around management of utilization, unit cost,
and service intensity. Responsible for accurate and reliable actuarial
activities. Ensure sound actuarial analysis of risk, resulting in the
attainment of PacificSource’s financial and enrollment goals. Work to
increase enrollment and maintain a strong financial position. Provide
documented input on decisions which impact the risk assumed through
various current or proposed activities. Manage and provide leadership
and vision to team of analysts. Provide guidance to team members
regarding company policies, mandates, and workflow. Oversee hiring,
productivity, and quality of the team’s work.

Essential Responsibilities:

• Direct health economics strategy. Work with VP/Chief Actuary, Health
  Services, Provider Network, Actuarial Pricing and other leadership
  areas to ensure consistency with partnering departments and
  alignment with company strategy/goals.
• Make documented recommendations based on the analysis of information
  regarding methods to reduce costs.
• Collaborate with pricing actuaries to ensure actual and/or expected
  outcomes of health economics programs are reflected in premium
  rates. Provide actuarially sound pricing assumptions and analysis,
  including supporting actuarial memoranda where necessary.
• Coordinate business activities by maintaining collaborative
  partnerships with key departments.
• Actively participate in various strategic and internal committees in
  order to disseminate information within the organization and
  represent company philosophy.
• Provide leadership and supervision to a team of actuarial students,
  credentialed actuaries, and non-actuarial analysts.
• Assist with hiring, staff development, coaching, performance
  reviews, corrective actions, and termination of employees. Provide
  feedback, including regular one-on-ones and performance evaluations,
  for direct reports.
• Provide input into operational and strategic initiatives as they
  relate to the actuarial functions of the company.
• Participate in the design and execution of research activities
  performed within PacificSource.
• Responsible for process improvement and working with other
  departments to improve interdepartmental processes. Work with staff
  to promote utilization of lean methodologies for continuous
  improvement throughout the department.
• Directs the assessment of various elements of risk, cost, and
  utilization, and its financial impact upon PacificSource.
• Responsible for developing the organization’s targeted cost and
  utilization trend through regular and systematic analysis of
  experience and forecasting of financial and statistical data in a
  manner that is actuarially sound, competitive in the marketplace,
  and provides income in accordance with organization goals and
  objectives.
• Manage the develop ent, implementation, and maintenance of health
  economics models, coordinating with other departments to ensure
  compliance with regulatory requirements and consistency with
  PacificSource policies.
• Assist in the development and monitoring of clinical programs and
  provider contracts. Product development activities include:
  proposing program adjustments, creating organizational discipline
  around the management of cost and utilization trends, modeling risks
  and recommending provider contract parameters, reviewing draft
  provider contracts, monitoring accuracy of contract implementation
  and measuring contract performance, planning and execution of
  ongoing risk management, and making presentations to senior
  executive management.
• Stay informed regarding changes to actuarial curriculum and
  requirements. Propose updates to student program as needed.
• Assist in the development of department budgets.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and
  regulations concerning confidentiality and security of protected
  health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: At least six years health actuarial experience and
three years management experience required.