Director, Actuarial Services

Careers With Purpose

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.

Facility: GSS National Campus
Location: Sioux Falls, SD
Address: 4800 W 57th St, Sioux Falls, SD 57108, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00

Department Details

Relocation is not required; however, we believe the right leader will be meaningfully connected to our Upper Midwest footprint. As the nation's premier rural health care system, Sanford partners closely with communities across the region to deliver innovative, high-quality care.

Job Summary

Manage and apply resources to general actuarial service operations, guided by experience, organizational goals and operational strategies. Responsible for oversite and direction of the underwriting team. Provides block-level pricing consultation for large fully insured and self-funded groups, small groups, individual lines, including Medicare and Medicaid. Works with internal and external resources to analyze and assist with product level premium rate filings. Work on complex actuarial matters where analysis of issues, data and process require advanced specialist knowledge and in-depth industry and technical knowledge.

Support and provide leadership on all aspects of the enterprise actuarial functions, balancing growth and profitability goals. Rely on extensive experience and judgment to plan and accomplish goals with a wide degree of creativity and latitude.

Develop the enterprise premium rate structure through actuarially sound and competitive regular and systematic analysis and forecasting of financial and statistical data, and provide income in accordance with enterprise goals and objectives.

Provide support as needed in order to evaluate and create programs to address all areas of financial risk appropriately. Provide actuarial analytical support, pricing, reserve analysis, loss experience, rate filings, underwriting, program profitability and performance.

Oversee the Underwriting function that primarily includes large group renewals. Develops policies and procedures and ensures department compliance with federal and state laws. Provides sound underwriting practices for optimal financial performance. Manages staff to analyze and communicate observations regarding claims utilization and cost trends to management team, agents, brokers and employer groups. Responsible for providing support for clients in current and future benefit decisions. Must be able to demonstrate use of their knowledge in optimizing the financial integrity and system of various healthcare activities.

Support monthly financial process with needed analysis to evaluate variance between budget and actual results by line of business. Conduct ad hoc program loss experience reviews and reporting and analysis, including trend analysis by line of business.

Analyze current and past trends in key performance indicators, including utilization and unit price trends: conduct quarterly and monthly financial reporting, budgeting and forecasting. Analyze complex financial information and reports to provide accurate and timely actuarial recommendations to management.

Collect, analyze and interpret loss experience data, including estimating Insurance incurred but not reported (IBNR) reserves and forecasting current new business and renewal rate levels.

Develop ad hoc analyses or data to support strategic goals and communicate to management.

Qualifications

Bachelor's degree in mathematics, finance, business or related field.

Five years of experience in health insurance or managed care required. Experience with Affordable Care Act (ACA) pricing, large group pricing and underwriting, stop loss/self-funding, Incurred But Not Reported (IBNR) development are highly valued. Experience managing other actuaries/underwriters is required. Experience with SAS/SQL is highly valued.

Associate of the Society of Actuaries (ASA) designation required. Current Fellow of the Society of Actuaries (FSA) designation or desire to attain FSA designation is preferred. Member, American Academy of Actuaries (MAAA) and Society of Actuaries (SOA) with qualifications to provide statements of actuarial opinion preferred.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call View phone number on click.appcast.io or send an email to View email address on click.appcast.io .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0261331
Job Function: Health Plan
Featured: No