at Cook County Government in Chicago, Illinois, United States
Job Description
Job Posting:May 9, 2024, 2:08:25 PMClosing Date:May 24, 2024, 4:59:00 AMFull-time
A.M.
P.M.
Collective Bargaining Unit:NonePosting Salary:COMPETITIVE SALARY
Organization:Health and Hospital Systems
JOB SUMMARY
LOCATION: JOHN H. STROGER, JR. HOSPITAL
SHIFT: DAYS
The Director Actuarial Services, Health Plan Services will lead, manage, and coordinate the analytical efforts supporting the rate setting process for CountyCare and Medicare programs to ensure rates are competitive, adequate, and actuarially sound. Serves as a subject matter expert and trusted advisor for health plan leadership. The Director will be responsible performing duties that include, but not limited to, competitive analysis, network analysis, risk adjustment, analyzing trends, actuarial benefit value analysis, etc. and determining the implications on premiums, risk adjustment, and strategic initiatives.
This position is exempt from Career Service under the CCH Personnel Rules.
Typical Duties
Serves as a subject matter expect overseeing all aspects of the rate setting process.
Collects and analyzes claim and membership data to estimate potential liabilities.
Leads and manages the risk adjustment processes and operations
Develops and projects actuarial models.
Assists in the development of financial forecasts and projections including the identification of risks and opportunities.
Provides insight and support for the reinsurance placement process.
Recognizes and prepares opportunities to enhance analyses and improve efficiencies.
Develops reserves and submits the documents for the incurred but not reported (IBNR) reporting.
Reviews and analyzes regulations and potential impacts on the health plan.
Prepares and submits all required state and regulatory report filings
Supports medical economics and network pricing analysis by participating in contract negotiations focusing on strategic the rate setting process that will be implemented with Medicaid.
Assists in the development of the Medicare bid.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
Attends and participates in meetings, groups discussions, and committees as required.
Performed other duties as assigned.
Minimum Qualifications
Bachelor's degree in Actuarial Science, Economics, Mathematics, Applied Statistics or related field from an accredited college or university (Must provide official transcripts at time of interview)
Credential in one of the following: Associate of Society of Actuaries (ASA) or Fellows of the Society of Actuaries (FSA) designation or Chartered Enterprise Risk Analyst (CERA) (Must provide proof at time of interview)
Four (4) years of actuarial experience
Three (3) years of supervising and/or managing staff
Prior actuarial experience in health care developing program rates and pricing methodologies for Medicaid and Medicare
Advanced proficiency in Microsoft Office Excel
Preferred Qualifications
Master's degree from an accredited college or university (Must provide official transcripts at time of interview)
Prior experience in a leadership role within a Medicaid and Medicare health plan
Proficiency with SAS and/or SQL
VETERAN PREFERENCE
PLEASE READ
When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service
To take advantage of this preference a Veteran must:
Meet the minimum qualifications for the position.
Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable
OR
A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.
If items are not attached, you will not be eligible for Veteran Preference
VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.
BENEFITS PACKAGE
Medical, Dental, and Vision Coverage
Basic Term Life Insurance
Pension Plan
Deferred Compensation Program
Paid Holidays, Vacation, and Sick Time
You may... For full info follow application link.
COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER
To view full details and how to apply, please login or create a Job Seeker account