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Director, Actuarial Services (Reserve) - Remote, Work From Home

  • Job ID: 044627946
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Actuarial
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $0 / hour

Description

Purpose:
To ensure that the UPMC HP actuarial department provides the following services to various in-house clients

Responsibilities:

  • Reserving: Works with the financial reporting department to develop reserve amounts for IBNR claims, active claims and premium deficiency reserves on a regular or as-needed basis across all product lines.
  • Manage Actuarial Reserve Department: Supervise Actuarial department and various entities within UPMC Health Plan as needed to ensure department goals and objectives are met.
  • Work with the UPMC HP Appointed Actuary to ensure satisfactory filings of annual Statements of Actuarial Opinion and associated memoranda.
  • Supervise Actuarial department personnel to ensure that departmental objective and goals are achieved in a timely manner
  • Forecasting: To provide UPMC HP senior management with regular and ad hoc reports which communicate current and future near- and long-term projections of financial performance of the various health product lines in order to facilitate corporate decision and the development of corporate strategies and goals.
  • Compliance: Ensure that all required statutory rate filings are submitted appropriately, and that all rates, factors and methods are in compliance with applicable state and federal regulations. Ascertain and comply with filing and actuarial requirements for participation in government-sponsored health plans as appropriate.
  • Additional Business: Ability to learn new lines of business to help UPMC Health Systems to expand into different arenas such as Stop Loss Insurance or Workers Compensation.
  • Consultant within UPMC Health System; Act as an Actuarial Consultant within the UPMC Health System and perform various activities, Including IBNR calculations, Data Analysis.
  • Ensure that the departmental work products meet the highest standards of quality

 

Qualifications

Qualifications - Internal

  • Minimum Bachelor's degree in mathematics, statistics, actuarial science, economics or related field. Advanced degree preferred
  • 8 plus years of experience in progressively more responsible actuarial work in health insurance/managed care or equivalent training/education
  • Experience with both commercial and government health programs preferred, specific involvement with the new MMA regulation; in-depth understanding of health insurance market dynamics.
  • Excellent problem solving and analytical skills.
  • Good oral and written communication skills.
  • Strong PC skills.
  • Data retrieval skills and relational database experience.

    Licensure, Certifications, and Clearances:
  • ASA or FSA certification by Society of Actuaries required.
  • Membership in the American Academy of Actuaries required.
  • Associate of the Society of the Actuaries Certificate OR Fellow of the Society of Actuaries Certificate
  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct