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Job Title:
Director of Actuarial and Risk Adjustment Services

Cost Center:
682891378 SHP-Actuarial

Scheduled Weekly Hours:
40

Employee Type:
Regular

Work Shift:
Mon-Fri; 8:00 am - 5:00 pm (United States of America)

Job Description:

JOB SUMMARY

The Director of Actuarial & Risk Adjustment Services is a key leader for commercial and government program actuarial and risk adjustment topics. This role provides financial guidance to organizational executives and system executives regarding insurance risk evaluation, premium rate setting, risk adjusted revenue process, merger and acquisition activities and assistance with strategic positioning of the integrated health system. The Director of Actuarial & Risk Adjustment Services partners with the Chief Actuary to lead unit development and execution of strategy through tactics, actions, processes, plans, and analytical tools to deliver data-driven solutions that positively impact the improvement of members' health and lower the total cost of care. The Director of Actuarial & Risk Adjustment Services manages and directs a team of actuaries and analysts.

JOB QUALIFICATIONS

EDUCATION

For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

Minimum Required: Bachelor's degree in mathematics, statistics, actuarial science or related field.

Preferred/Optional: None

EXPERIENCE

Minimum Required: Ten years of progressive actuarial experience. Three years management experience.

Preferred/Optional: Experience in pricing, reserving, analysis and other actuarial functions. Working knowledge of overall market trends and industry practices related to health insurance.

CERTIFICATIONS/LICENSES

The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

Minimum Required: Associate of the Society of Actuaries and Member of the American Academy of Actuaries.

Preferred/Optional: Fellow of the Society of Actuaries.

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.

Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.

Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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