Actuarial Lead

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

Under the supervision and guidance of the Manager, Actuarial Reserving, Forecasting & Risk Management Support, the Actuarial Lead position supports analysis, data collection, and other operational support for internal and external Actuarial/Underwriting deliverables with a focus on supporting the monthly IBNR Reserve, budgeting, and forecasting, and MLR model maintenance and analysis.
This position represents actuarial in many cross functional teams.

Principal Duties and Responsibilities:

• Supports reserving analysis and communication of financial results to senior leadership.
• Responsible for monthly IBNR and other actuarial accruals (MLR Rebate, risk adjustment, PDR, Provider Bonus, High-Cost Risk Pool, etc.).
• Quarterly forecasting of Mass General Brigham Health Plan financial statements for purposes of business planning.
• Responsible for monthly MLR models update and communication of results to Pricing and UW; this includes but not limited to data analysis, identifying trends, monitoring performance, and making model adjustments.
• Ability to respond to sales, product, or accounting areas questions on actuarial deliverables.
• Responsible for explaining and monitoring Mass General Brigham Health Plan revenue and medical claims variances against the budget.
• Annual update of actuarial memorandum and support of actuarial memorandum.
• Support annual audits (Mass General Brigham Health Plan and Mass General Brigham close) in addition to triennial DOI audit.
• Inform, engage, inspire, motivate, and actively listen to employees.
• Hold self and others accountable to meet commitments.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

Qualifications:

• Bachelor’s degree in Mathematics, Statistics, or another quantitative discipline (Physics, Engineering, Quantitative Finance, Mathematical Economics, etc.) required or the equivalent combination of training and experience
• 5 years of actuarial experience required.
• Understanding of reserving models, health insurance data sets, and product compliance testing is a plus.
• Completion of 3 actuarial exams is required.
• Microsoft Office, VBA, SAS, SQL a plus

Skills/Abilities/Competencies:

• Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value.
• Bring fresh ideas forward by listening to and working with employees and the people we serve.
• Respect the talent and unique contributions of every individual and treat all people fairly and equitably.
• Strong, demonstrated track record of an ability to execute on time, on budget, and scope.
• Strong aptitude for technology-based solutions.
• Ability to inject energy, when and where it’s needed.
• Current in healthcare trends.
• Demonstrated forward, visionary thinking; ability to see “what is” and envision “what could be.”
• Ability to develop, introduce, defend, and gain support for new ideas and approaches.
• Excellent leadership skills and leadership track record.
• Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience, strong executive presence, presentation, and communication skills. Strong verbal, active listening and written communication skills are required.
• Ability to view the long-range trends and cycles of the business and industry and see the “big picture.”
• Ability to apply a variety of strategic frameworks to analyze problems and to guide and develop solutions.
• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy.
• Excellent interpersonal skills, including the ability to influence others at all levels of an organization.
• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
• Unquestionable integrity.

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.