Director of Actuarial + Underwriting Operations

Health Partners is hiring a Director of Actuary and Underwriting
. This role is responsible for:

• Managing the design and development of methods for extracting data for actuarial reporting and analysis, underwriting applications, and regulatory reporting
• Operations of the Actuarial & Underwriting team including self‑insured billing, discount analysis and UDS support, legal data requests, and overseeing the production and analysis of standard and customized reports and data for employer groups, and
• Reinsurance - requires an in-depth understanding of the organizations’ data and systems along with in depth knowledge of the business of health care insurance (both government programs and commercial). Hire, train, and coach a staff of programmers and data analysts with a high level of technical skills.

• Bachelor’s degree in Business Administration, Mathematics, Accounting, IT, or Statistics, Management Information Systems, Computer Science or related field. Master’s degree preferred.
• 10 years’ managed care experience with direct experience in employer reporting, reinsurance, informatics, statistics or related experience.
• 8 years’ previous management experience.
• Relevant health plan or health insurance experience. Experience with actuarial science and/or health underwriting.
• Prior experience in the development and implementation of complete data sets and interpretation methods to produce actionable information.
• Experience with data operations and data science.
• Thorough knowledge of current healthcare business, insurance risk management, software technology, database, query languages, and end‑user software.
• Experience in MS Azure/Cloud data source.
• Advanced data modeling and AI.

This role leads various teams that support key rating and analysis functions within Actuarial and Underwriting. These teams are:

• Data and Programming Team – This team builds and maintains data assets used by various Actuarial and Underwriting teams that conduct rating and analysis work. These data assets must be built to be compliant with various Actuarial Standards of Practice at the direction and requirements of the Actuarial Leadership Team and the Underwriting Leadership Team. This work includes periodic reconciliation and accuracy validation.
• Underwriting Support Team – This team is responsible for a wide variety of rating and risk analysis support function including UDS data submissions, claims repricing and discount analysis.
• Self‑Insured Billing System Team – This team is responsible for stop loss accounting and all other billing and claim reconciliation support functions for self‑insured group billing/invoicing.

Besides the management of the above teams, this role will be part of the leadership required for all major related process reengineering efforts and technology implementations that are used by Actuarial and Underwriting.

• (30%) – Team leadership, management and development of human capital.
• (30%) – Project management of major team deliverables. This includes standard cadence deliverables as well as support for major implementations of data assets, technology and process changes. Data assets supporting Actuarial and Underwriting processes must be built in compliance with related Actuarial Standards of Practice.
• (20%) – Decision making regarding insurance risk situations such as stop loss management and billing, data and reporting releases to brokers and client groups, etc.
• (20%) – Collaborate closely with Data Ops, Informatics, Sales & Account Management, Operations Areas, Legal, Compliance, etc.