Analytic Manager, Actuarial Services - Credentialed

We enjoy the important work we do every day on behalf of our members.

Job Summary

This managerial position will lead a portfolio of initiatives to support pricing, medical trend and revenue analytics for Tufts Health Plan Senior Products. It will have a staff of healthcare analysts, actuarial students and/or credentialed actuaries. This position will require mentoring and training of staff and will support recruiting and development activities.

This position will need to work in multi-departmental teams to support project assignments that include some or all of the following: annual development of the Part C Medicare Bids, support of the Part D Bids, Part C and Part D portfolio analysis, medical and pharmacy product management support, financial planning and projections, trend analysis, product development, and geographic expansion evaluation. This role will work closely with a variety of THP departments including Product Management, Medical Management, Finance, Contracting, and Sales.

An understanding of the health insurance industry, strong interpersonal skills and technical proficiency in relational databases, data warehouses, Excel and statistical modeling are required.

Job Description

Managerial Responsibilities

• Recruits, trains, develops and supervises analyst and/or management-level staff, through direct or matrix reporting
• Identifies and addresses development needs of Actuarial Analysts and Associate Actuaries through coaching and oversight

Planning, Design, Project/Process Management

• Assists Director in translating corporate and department goals into specific initiatives (specific examples in job descriptions). Leads some cross-function processes. Integrates work across business functions within/outside department, and external to THP where relevant.
• Assists Director in developing appropriate staffing or team organization to support objectives.  Sets standards and goals for individual and team performance.

Technical Analysis

• Evaluates current technical  processes developed by their team and/or others and makes suggestions for improvements and/or increased efficiency
• Defines key objectives of technical processes developed by others and assures deliverables meet stated objectives
• Designs and builds technical processes to address business issues
• Provides input into and/or help structure program code for more junior staff
• Oversees the technical work of others

Checking/Validation/Peer Review

• Assists Director in defining quality standards and acceptable tolerance levels for error
• Develops criteria to validate results in light of prior expectations.  Investigates unusual results and offers explanations.
• Assists colleagues and more junior staff with validation/checking activities
• Ensures the accuracy of deliverables through oversight of the work of others
• Conducts peer review. Challenges results and assumptions to assure quality and accuracy.

Analysis/Interpretation

• Examines and interprets results in the context of the specific business questions being addressed
• Identifies new questions and/or unforeseen data complexities arising from results and takes steps to address them
• Integrates information from multiple sources to interpret results in larger business context
• Vets results with organizational stakeholders to gain alternative views and reach agreement on interpretation
• Identifies implications of results for departmental or corporate action (e.g., new programs, new methodology, key business decisions)

Communication/Presentation of Results

• Assists Director in leading decision-making processes using analytic results
• Packages results to demonstrate link between analysis and broad business context
• Ensures that deliverables meet stakeholder needs and are packages and presented to facilitate understanding and action
• Packages and presents results to draw conclusions and influences decision-making by senior management

Other duties as assigned

Requirements

Qualifications :

• Master’s in related field or equivalent education/training
• 8+ years of responsible healthcare actuarial experience including at least 3 years of product line revenue-based activities.
• ASA or FSA designation

Skill requirements:

Management:

• Able to develop and lead junior managers/highly skilled individual contributors.  Assist Director in managing change and motivating teams to be high performing.
• Experience managing teams and individuals in a direct report and/or matrix environment
• Able to mentor and develop staff using situational leadership techniques

Analytic: 

• Demonstrated experience in analytic project design

Technical: 

• Proficiency in the use of personal computers
• Sufficient understanding of relational databases, statistical packages, spreadsheet and/or database applications to oversee work of others

Communication/Presentation skills: 

• Assists Director in influencing development of future corporate and departmental goals related to area of expertise
• Highly developed verbal and written skills
• Ability to facilitate planning and review sessions with senior THP management
• Well developed presentation skills; presents to senior THP management
• Able to effectively manage difficult group dynamics to effectively reach a positive outcome.
• Able to present to highest level of company management

Negotiation/Leadership skills: 

• Able to operate in a matrix environment
• Able to implement Actuarial department standards and processes
• Able to identify issues and roadblocks and participate in their resolution
• Able to influence and resolve conflict within own staff and/or project team
• Well-developed skills to influence interdepartmental teams, steering committees and senior management 
• Able to navigate political issues using advanced organizational knowledge 

Independence/Judgment: 

• Applies own judgment with consultation from Director as needed on the design, organization and implementation of projects and processes

Interpersonal skills (include personal interaction):

Must be able to work cooperatively as a team member.  Regular interface with various levels of Tufts leadership, staff and providers is required as well.

Confidential data

All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential.  Will be exposed to and required to deal with highly confidential and sensitive material.  Must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Working conditions or additional requirements (include special requirements, e.g., lifting, travel, overtime)

Unlimited access to confidential member and provider specific data.

Fast paced office environment.  Works on personal computer approximately 70% of the time.  Must be able to exercise appropriate judgment, as necessary.  Open cubicle work setting with personal computer. 

What we build together changes our customer's health for the better.  We are looking for talented and innovative people to join our team.  Come join us!

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