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Senior Actuary

Highmark Health
Honolulu, HI Full Time
POSTED ON 1/19/2025 CLOSED ON 4/19/2025

What are the responsibilities and job description for the Senior Actuary position at Highmark Health?

This is an individual contributor, credentialed actuary position. Participates in Highmark's Actuarial Executive Development Program. Utilizes subject matter expertise and advanced industry knowledge to define & diagnose a problem, outline data requirements for a study or analysis, and devise insightful and creative solutions, demonstrating accountability and ownership of results. Demonstrates broad expertise and ingenuity and will be sought out by others for advice on methodology, strategy, and delivery of results. Engage, motivate, and mentor less experienced staff and provide decision support to team members while initiating and leading actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers. Effectively advocates across the entire corporation for appropriate positions, processes, and systems which can reasonably be adopted. Displays an ongoing commitment to continuous learning and self-improvement by independently seeking out the use of both internal and external sources. Applies actuarial techniques and statistical analysis to several functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving.

ESSENTIAL RESPONSIBILITIES

  • Independently manage the time and resources of both themselves and others involved in many cross departmental projects.
  • Demonstrate responsiveness, confidence, and flexibility in the wake of change.
  • Effectively implement a range of coping mechanisms in the face of adversity.
  • Anticipate, absorb, adapt to and rapidly recover from a potentially disruptive event.
  • Thrive in a dynamic, changing environment and approach new challenges with anticipation and a view towards success.
  • Proactively identify emerging opportunities; establish project objectives, specify strategies, and organize necessary tasks.
  • Keep manager informed.
  • Utilize subject matter expertise and industry knowledge to define & diagnose a problem.
  • Outline data requirements for a study or analysis and devise insightful and creative solutions, demonstrating accountability and ownership of results.
  • Independently initiate and lead the development of complex studies, expert analyses, and presentation materials needed to appropriately inform decision makers.
  • Uncover the root causes of problems, rejecting superficial explanations.
  • Review the appropriateness of the results in light of experience and industry knowledge.
  • Consider alternate explanations or viewpoints before drawing conclusions.
  • Make appropriate recommendations while understanding the implications and consequences to all stakeholders.
  • Interact with stakeholders in a manner that fosters cooperation and teamwork while conveying engagement, competence and ownership of outcomes.
  • Enhance department influence by providing responsive service and understanding customer needs.
  • Effectively and confidently present information and provide decision support to team members and executive management.
  • Appropriately balance the need for clarity and brevity with the need to fully inform customers of all aspects of a situation which may be material to a decision.
  • Anticipate a customer's needs and proactively crafts message to address.
  • Consider alternate points of view on issues, demonstrating sensitivity to others' situations.
  • Maintain positive, productive working relationships despite differing or conflicting situations and personalities.
  • Correctly interpret direct and indirect messages and verbal and non-verbal behaviors and respond appropriately.

Exhibit a thorough understanding of both corporate and division goals and values. Apply corporate, professional, and industry knowledge & insight to all tasks under incumbent's control or influence. Use expertise to envision and implement innovative new processes and propose changes to existing processes, leading to improved outcomes that better conform to corporate goals, objectives, and values. Demonstrate a capacity to shift between big picture and detailed thinking when analyzing issues and their strategic importance and take calculated risks to accomplish organizational objectives. Effectively advocate across entire corporation for appropriate positions, processes, and systems which can reasonably be adopted.

Proactively ensure the internal and external consistency of all work, demonstrating ownership and accountability of results. Use advanced industry knowledge to perform reasonability checks as well as exceed customer expectations. Demonstrate broad expertise and ingenuity, and as a result is sought out by others for advice on methodology, strategy, and delivery of results. Promptly and efficiently identify outliers and anomalies in the work of others. Identify methods to test whether suspect results are correct. Form reasonable approximations in advance of results of an analysis and determine whether deviations are reasonable or suspect. Display an ongoing commitment to continuous learning and self-improvement by independently seeking out the use of both internal and external sources.

Engage, motivate, and mentor less experienced staff on a regular basis in positive a manner that fosters teamwork and excellence, including developing the ability of others to perform and contribute to the organization by providing ongoing feedback and opportunities to learn. Represent department's perspectives and needs on large corporate initiatives and negotiate appropriate compromises and solutions in a way that results in effective action. Proactively tailor work to the anticipated needs of direct management and business partners and make recommendations that have an impact beyond their role. Assume responsibility for own actions and the consequences for actions undertaken and decisions made. Demonstrate assertiveness and self-assurance in resolving conflictive situations and / or standing by unpopular decisions.

EDUCATION

Required

  • Bachelor's Degree in Actuarial Science, Mathematics, Statistics or closely related field
  • Substitutions

  • None
  • Preferred

  • None
  • EXPERIENCE

    Required

  • 5 years Actuarial experience in area of specialization
  • Preferred

    Pursuing FSA exams towards FSA Certification

    Prior pharmacy experience with a pharmacy benefit manager (PBM), consultant, pharmacy provider, or another organization specializing in pharmacy

    LICENSES AND CERTIFICATIONS

    Required

  • Associate of the Society of Actuaries (ASA)
  • Preferred

  • Fellow of the Society of Actuaries (FSA)
  • SKILLS

    Possesses and applies a comprehensive and in-depth knowledge of actuarial principles, concepts, practices and processes within two or more fields of specialization.

    Possesses significant expertise to complete complex assignments and ability to visualize, articulate, and solve complex problems while leading others to complete complex assignments.

    Develops, designs, and leads analytic frameworks to solve complex problems using innovative approaches.

    Analytical Skills

    Solves complex problems taking a broad perspective and developing innovative solutions.

    Thrives in a dynamic, changing environment and approaches new challenges with anticipation and a view towards success.

    Language (Other than English) :

    None

    Travel Requirement : 0% - 25%

    PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

    Position Type

    Office-based

    Teaches / trains others regularly

    Frequently

    Travel regularly from the office to various work sites or from site-to-site

    Rarely

    Works primarily out-of-the office selling products / services (sales employees)

    Never

    Physical work site required

    Frequently

    Audible Speech

    Constantly

    Hear

    Constantly

    Position self or move lower on ground, under tables / desks, etc.

    Never

    Climb

    Never

    Drive

    Occasionally

    Reach

    Frequently

    Sedentary position

    Frequently

    Move

    Frequently

    Repetitive Motion

    Frequently

    Use Hands / Fingers to Handle or Feel (beyond just data entry)

    Frequently

    Frequently

    Vision – Far, Near, Depth Perception

    Frequently

    Move, transport, transfer – up to 10 lbs (Sedentary Work)

    Occasionally

    Move, transport, transfer – up to 20 lbs (Light Work)

    Occasionally

    Move, transport, transfer – up to 50 lbs (Medium Work)

    Occasionally

    Move, transport, transfer – excess of 50lbs (Heavy Work)

    Never

    Disclaimer : The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

    Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

    As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

    Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

    Pay Range Minimum : 92,300.00

    Pay Range Maximum : 172,500.00

    Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

    Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.

    EEO is The Law

    Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ( https : / / www.eeoc.gov / sites / default / files / migrated_files / employers / poster_screen_reader_optimized.pdf )

    We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

    For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

    California Consumer Privacy Act Employees, Contractors, and Applicants Notice

    J-18808-Ljbffr

    Salary : $172,500

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