Aetna Actuary I - 51514BR in Dallas, Texas

Req ID: 51514BR

The ideal candidate will be based near our Sugar Land, TX, Dallas, TX or Walnut Creek, CA office

POSITION SUMMARY

This role is responsible for driving discount improvement inclusive of contracting changes and data submission impacts for all markets within an assigned territory. Coach a group of actuarial staff in support of department mission to protect Aetna's financial integrity. Collaborate with business partners to provide sound risk management advice. Anticipate and recognize matters that materially affect financial results and make sound, unbiased recommendations on these matters. Lead interdepartmental teams to shape policy and process.

Fundamental Components:

The position is accountable for serving as the liaison between the local market, Actuarial and MEU on the discount process.

Management of Resources

  • Lead/manage projects established to support goals identified in strategic and operating plans. Influence/motivate resources within and outside of direct control to complete projects. Exhibit innovative use of resources.

  • Scope of Decision Making Authority- Broad decision making authority typically tied to level of financial impact.

  • Aetna Way- Exhibit behavior that reflects Aetna's values and is in accordance with the Aetna Way.

    Product & Business Knowledge:

  • Assumptions & Data Sources- Review assumptions developed by staff from a business perspective and be able to defend work to senior management. Integrate understanding of internal and external data sources for quantifying risks.

  • Programs, Policies & Processes- Apply knowledge of interdepartmental products, programs, processes and policies to resolve problems and issues.

  • Regulatory Issues- Assure compliance with applicable regulations, laws and standards.

    Risk Analysis & Management:

  • Risk Assessment- Partner with business managers to provide sound risk management advice.

  • Planning & Forecasting- Review and interpret models and make recommendations for planning, forecasting and reporting process.

  • Pricing, Trend & Benefit Design- Oversee and recommend pricing and trend for product and/or services.

    Technical Proficiency:

  • Use of Technology- Develop creative technical solutions to a variety of problems. Stay apprised of technical innovations as potential solutions for actuarial issues and concerns.

    BACKGROUND/EXPERIENCE desired:

    Bachelor's degree along with 5 years experience in Actuarial or MEU.

    Network contracting or knowledge of the discount process is a plus.

    Strong communication skills to work with market area leaders.

    Healthcare background is required.

    Must have a minimum of ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries)

    EDUCATION

    The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

    LICENSES AND CERTIFICATIONS

    Actuarial/Fellow of the Society of Actuaries is desired

    Actuarial/Associate of the Society of Actuaries is required

    LOCATION

    The ideal candidate should work in (or near) one of our offices; Sugar land, TX, Dallas, TX or Walnut Creek, CA

    ADDITIONAL JOB INFORMATION

    Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

    We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

    Together we will empower people to live healthier lives.

    Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

    We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

    Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

    Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

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Job Function: Actuarial

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.