Director, Actuarial Services

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
Nov 19, 2024
Oversee the pricing of HMSA's products for all lines of business, including the following: Pricing of new products/plans/benefits and modifications to existing plans/benefits. Regularly updating the rating methodology and factors for HMSA's non-ACA commercial group lines of business, including drafting and submitting the associated rate filings. Creating and/or certifying annual ACA individual and small group rate filings. Annually updating grandfathered individual rates and submitting the associated rate filing. Collaborating with HMSA's actuarial consultant to develop annual Medicare bid submissions and group retiree pricing. Partner with account management and underwriting staff on new and renewal rating discussions. Interface with external brokers, consultants, and accounts. Provide input regarding underwriting guidelines and procedures. Support the maintenance and enhancements of HMSA's commercial group rating engine. Oversee development and maintenance of actuarial/financial models of HMSA's value-based contracting (VBC) arrangements in alignment to corporate goals and strategy. Analyze, report, and forecast impacts of VBC model changes to HMSA's finances. Create revenue and expense projections at the line of business level. Monitor emerging experience against these projections and produce variance analyses on a regular basis. Manage staff in the Actuarial Unit, including: Recruit, train and coach staff. Maintain actuarial study program to encourage formal actuarial education. Ensure that all work is performed in compliance with the applicable Actuarial Standards of Practice and follows industry best practice. Implement performance standards and monitor staff performance against the standards, providing regular feedback and coaching in a timely manner; and implement performance improvement plans, as necessary. Develop the unit business plan and budget and oversee accurate allocation of unit and departmental costs based on program reporting requirements. Monitor emerging expense trends. Based on these and known/projected provider contract and other key drivers, oversee the development of trend forecasts to be used for financial projections and rating purposes. Perform all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid