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Aetna is now a CVS Health Company

Director, Actuarial (Cred)

Primary Location: Linthicum, MD
Additional Locations: MD-Linthicum, MD-Rockville, VA-Falls Church
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Description:
Manage/coach a multi-functional group of actuarial staff in support of department mission to protect Aetna’s financial integrity. Lead/manage projects in support of strategic and operating plan goals. Negotiate and influence sound business decisions by adhering to established risk management principles. Anticipate and recognize matters that materially affect financial results and make sound, unbiased reports on these matters. Participate on work groups/ forums representing Aetna to external constituents. You'll lead the actuarial support for the MD/NJ/VA Medicaid markets. Key responsibilities include; revenue rate advocacy and negotiations with States, policy advocacy with States, forecasting, reserving, run rate analytics, and cost savings initiatives support.

Fundamental Components:
Leadership:
- Management of Resources- Lead/manage projects established to support goals identified to support goals identifies 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- Broad decision making authority typically tied to level of financial impact.
- Staffing/Personnel- Develop a high performing team, including responsibility for hiring and termination decisions. Perform all other supervisory responsibilities for unit, including job coaching, performance reviews, and compensation determinations. Ensure access to appropriate tools, resources and training.
- Aetna Way- Foster 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 influence senior management to accept alternative recommendations. Integrate understanding of internal and external data sources for quantifying risks.
- Programs, Policies & Processes- Apply knowledge of corporate 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- Provide leadership in the negotiation and influencing of sound business decisions through adherence to established risk management principles. - Rate Filing- Facilitate regulatory process. Respond to internal and external auditors. Validate and/or sign certifications of compliance.
- Reserve Analysis- Review reserve recommendations and set adequate reserve levels.
- Planning & Forecasting- Review recommendations and set forecast in collaboration with finance and business partners.
- Pricing, Trend & Benefit Design- Partner with business owners in decision making process around pricing and trend.
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.
- Development & Implementation- Oversee/manage the development and implementation of tools and models.
- Maintenance & Enhancements- Manage cost to implement and prioritize changes to processes, tools and systems. Present to senior management to approve funding.
- Business Specifications- Signoff detailed business requirements for system development.
- Testing- Review testing results for changes to processes, tools and systems. Communication, Collaboration & Consultation:
- Constituent Focus- Lead interdepartmental teams to shape process and policy. Represent Aetna on industry workgroups/SOA or Academy forums.
- Verbal & Written Communication- Address most complex business issues. Have direct interaction with internal and external constituents. Maintain accurate documentation and consult on training and user support for tools and processes.
- Interaction with Constituents- Promote an environment where collaboration is encouraged and rewarded.

Background Experience:
- Bachelor's degree along with a minimum of 7+ years related work experience in the healthcare field.
- Must be an ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) and a member of the American Academy of Actuaries able to sign state rate filings and other required actuarial certifications.
- Demonstrated focus on process improvement and use of creative thinking to solve business challenges is required
- Strong management experience along w/excellent communication skills
- Prior Medicaid experience desired (not required) but must have healthcare experience


Additional Job Information:
Leading the actuarial support for the MD/NJ/VA Medicaid markets. Key responsibilities include revenue rate advocacy and negotiations with States, policy advocacy with States, forecast, reserving, run rate analytics, and cost savings initiatives support.

Required Skills:
General Business - Communicating for Impact, General Business - Consulting for Solutions, Leadership - Collaborating for Results

Desired Skills:
Leadership - Driving Change, Leadership - Driving Strategic and Organizational Agility, Leadership - Engaging and Developing People

Potential Telework Position:
Yes

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

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

Candidate Privacy Information:
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.

Click To Review Our Benefits (PDF)

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