This position is responsible for leading and managing actuarial professional teams to provide analytical and actuarial expertise to support these business areas and staff.
- Product and rate development
- Large group rating methodology program-wide with corresponding actuarial rate modeling support
- Large group actuarial pricing for:
o The California regions,
o Federal Employees Health Benefits Program (FEHBP)
o National Accounts
o KP employee health benefits plan (House Account)
- KP Individual Plan (KPIF) - Responsible for California function, national leadership role
- California Small Group actuarial pricing
- Coach, mentor and develop Actuarial staff
- Promote and model actuarial and business practices across the regions consistent with KP core and desired behaviors
Essential Functions:
- Lead California actuarial support of all commercial large group business lines; ensure representation on Strategy groups, attendance at consultant gatherings and rate renewal meetings as required.
- Apply actuarial principles to support expansion strategies, mergers, acquisitions, market strategy, strategic responses to emerging competitive threats, and evaluate product development proposal (alternate funding arrangements, point of service, open access, PPO, Self Funding and alternate funding).
- Provide leadership on the actuarial aspects of the National Pricing System (NPS) and related applications, the rate modeling process and rating factor development for the regions outside of California. NPS is an enterprise-wide solution responsible for determining KP's large group rates, generating over $25 billion in annual revenue.
- Provide program-wide financial and strategic leadership for the Federal Employee Health Benefit Plan (FEHBP) line of business. This enterprise-wide account generates approximately $2 billion of KP's total large group revenue of $25 billion.
- Provide program-wide actuarial leadership for the National Accounts line of business, including strategy development and renewal negotiations for our largest accounts and process improvements to help manage this portfolio of business.
- Lead the internal actuarial team that provides benefit consulting and rate renewal analytics for the KP Group (aka 'House Account').
- Support and partner with regional staff to analyze individual and small group product line financials to determine premium rates, margin forecasts, and other product line evaluations.
- Oversee the issue resolutions stemming from the CDI /DMHC to ensure appropriate certifications and opinions to support regulatory rate filings.
- Drive standardization of tools and processes used by regional actuaries in supporting large, individual and small group business lines, including regulatory rate filings.
- Represent and educate actuarial work products and methodologies to both internal and external audiences.
- Define standards of expertise, levels and dimensions of professional development and assist in training pricing staff in the use of best practice models and other industry recognized pricing tools.
- Accountable for continuous process improvements to promote best practices in actuarial rating methods and modeling while leading cross-regional, cross-functional collaborations to realize organizational strategic initiatives, operational programs, and functional goals and objectives.
Qualifications:
Basic Qualifications:
Candidate must possess strong actuarial and health insurance technical expertise along with leadership and communication effectiveness. Specifically, candidate must have:
- Bachelor's degree in math, actuarial science, business, finance, economics or related discipline required.
- Extensive experience in health insurance leadership positions
- Demonstrated ability to negotiate 'win-win' situations as it relates to business decisions
- Influence leadership skills with ability to forge partnership with other leaders; acting as strategic and trusted advisor, thought partner
- Accreditation as a health actuary (FSA and MAAA).
- Must have a minimum ten years relevant consulting and/or management experience including large project management.
- Must have a minimum ten years health plan and/or health insurance actuarial and underwriting experience.
Preferred Qualifications:
- Master's degree or equivalent work experience preferred.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.