Job Description
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.
Work Shift:
8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours:
40 Compensation:
Union Position:
No Department Details 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. Job Description 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. 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 1-877-949-5678 or send an email to talent@sanfordhealth.org. The Sanford organization owns and manages multiple distinct brands, including Sanford Health, Marshfield Clinic, and Good Samaritan, as well as Lewis Drug, Sanford Health Equip, Solutions by Sanford, Great Shots, and Blue Rock Bar & Grill. 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. Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan. The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies. The organization's transformational virtual care initiative brings patients closer to care with access to 78 specialties. Learn more about Sanford Health's commitment to shaping the future of rural health care across the lifespan at sanfordhealth.org or Sanford Health News. Good Samaritan, one of the nation's largest nonprofit providers of senior care and services, is committed to transforming the aging experience through innovation, compassion and personalized care. As part of Sanford Health, an integrated nonprofit health system headquartered in Sioux Falls, South Dakota, Good Samaritan serves 10,000 seniors and offers access to a full continuum of care, including 94 rehabilitation and skilled nursing centers, 56 assisted living and memory care facilities, 44 independent living locations and 37 home health and hospice agencies. The senior care provider delivers services across the upper Midwest, with 70% of residents living in rural communities. Learn more about Good Samaritan's mission and commitment to delivering high quality senior care in rural America at good-sam.com.
