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Accounting & Finance WellCare - Accounting & Finance Leadership Careers

Actuary - Vice President Job

Full Job Title: VP Actuary

Job Number: 1805423

Locations:
Tampa, FL
Chicago, IL
Manhattan, NY
Louisville, KY
Cypress, CA
Newark, NJ
St Louis, MO
Atlanta, GA
Houston, TX
Columbia, MO
Columbia, SC
Omaha, NE
Lawrenceville, NJ

Date Posted: 2018-08-02

LOCATION: Tampa or Remote
DEPARTMENT: Actuarial Services
REPORTING TO: VP, Actuary

Responsible for leading a team of associates who perform actuarial work related to either the Medicaid or Medicare products of WellCare's business and to WellCare corporate functions including reserving, rate setting, forecasting, reporting, auditing, M&A analysis and RAPS functions. Manage a team of analysts and actuaries who provide timely, accurate, actionable data and analysis supporting the department, area, and corporate key initiatives. Oversee the development of analytics for strategic and operating decisions for senior management. Provide proactive analysis and recommendations to senior management

Essential Functions:

  • Provides leadership and direction to the assigned actuarial product team and works closely with product leadership team to advance WellCare’s strategic business goals.
  • Provides insight and strategy related to primary responsible role – Medicaid, Medicare, Exchange, or Corporate Functions – that improve WellCare’s profitability.
  • Provide the leadership and communication that builds support for corporate strategic business plans and encourages team to achieve key objectives.
  • Manage the monthly actuarial responsibilities for primary responsibility – Medicaid, Medicare, Exchange, or Corporate Functions.
  • Manage and develop actionable recommendations to management relative to all analysis.
  • Manage and perform monthly analysis identifying opportunities to reduce cost and utilization and provide recommendations to senior management.
  • Oversees Medicare and PDP bid strategy, analysis and submission.
  • Oversees Medicaid rate development to ensure accuracy, profitability, and actuarially sound rates.
  • Manage and supervise cross-functional teams to address key issues facing the organization.
  • Evaluate and assess the government reimbursement process to determine areas of risk and opportunity.
  • Oversee regional initiatives to improve operating results.
  • Lead, initiate, and develop key analysis to improve overall MLR results.
  • Develop and maintain relationships with and work closely with outside consultants and senior management to ensure that projects conform to Actuarial Standards of Practice.
  • Manage the monitoring of trends and changes in the actuarial field and healthcare industry and communicate findings to upper management and appropriate associates.
  • Maintain necessary continuing education requirements as required by the Society of Actuaries.
  • Provides technical direction to functional managers, directors, and management.
  • Recommends changes in area(s) policy and procedure.
  • Direct participation with executive management regarding strategic assessment of projects and processes.
  • Coordinate and participate in research-related activities including industry best-practices, research and development of models, tools, and data analysis projects, and experience studies.
  • Additional projects as assigned.
  • Make recommendations to Chief Actuary in overall business strategy, project planning and corporate risk assessment.
  • Coordinate and participate in research-related activities including industry best-practices, research and development of models, tools, and data analysis projects, and experience studies.
  • Provide research and analysis to support, and participate in legislative initiatives involving WellCare, government entities, the managed care industry, the health insurance industry, actuarial organizations, the healthcare industry, and other fields as needed.
  • Additional projects as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in a related field
    • Preferred A Master's Degree in a related field
    Candidate Experience:
    • Required 8 years of experience in Actuary functions within a significant health plan organiztion
    • Required 3 years of experience in leading corporate actuarial functions or leading team of acutaries
    • Preferred 2 years of experience in Experience presenting to and consulting with senior management on strategic decisions
    Candidate Skills:
    • Advanced Demonstrated leadership skills
    • Advanced Demonstrated written communication skills
    • Advanced Demonstrated interpersonal/verbal communication skills
    • Intermediate Ability to communicate and make recommendations to upper management
    • Intermediate Ability to effectively present information and respond to questions from peers and management
    • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
    Licenses and Certifications:
    A license in one of the following is required:
    • Required Associate of the Society of Actuaries (ASA)
    • Preferred Fellowship of the Society of Actuaries (FSA)
    Technical Skills:
      Languages:

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        Last Updated On: 12/9/2015