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Director, Actuarial Services

Company: Lumeris
Location: Dallas
Posted on: June 12, 2021

Job Description:

In order to apply for a position at Lumeris, you must create an account using your email address and a password of your choosing. This account will allow you to receive notifications each step of the way through the job application process. With these updates, you'll never have to wonder where you are in the process. Additionally, we can easily send pertinent documents to you for your review. Once you create the account, you may apply to any position you feel is a good fit without having to re-enter information. Thank you for your interest in Lumeris.


Director, Actuarial Services

Position Summary:

The Director, Actuarial Services will support Lumeris and its current and future clients in achieving their financial and clinical outcomes by providing expert actuarial advice and analyses. Responsibilities include but may not be limited to: Bid development and submission, premium rate analyses, medical economics and experience analyses, provider contract analyses, reserve calculations and analyses, and management and development of junior actuarial staff. This role will be client facing.

Job Description:

Role and Responsibility:

  • Develop the organization's premium rate structure through the forecasting of financial/ statistical data in a manner which is actuarially sound and competitive in the marketplace including cash flow analysis and financial projections
  • Identify and communicate opportunities to improve claims experience and financial performance through medical economics and experience analyses
  • Lead actuarial analysis and services in support of medical analysis, trend projections, and rate negotiations
  • Oversee and analyze financial and claims data to evaluate utilization and unit price trends
  • Assist with and participating in negotiations and presentations where appropriate
  • Lead multiple projects involving development of Medicare Advantage and multiple Part D bids
  • Assist in annual reserve calculations and financial statement filings, and be able to explain to clients
  • Develop pricing consistent w/ financial and business objectives
  • Develop and apply actuarial models to diverse client situations
  • Balance growth and profitability goals to maximum results
  • Design and oversee ad hoc health cost analyses
  • Lead training and management of staff
  • Manage client projects

Experience, Qualifications and Education:

  • ASA or FSA
  • Technical proficiency in all aspects of health care actuarial practice including pricing, reserving, and data reporting
  • Experience with complex actuarial projects that have a large financial and risk impact
  • Experience with Medicare Advantage bid preparations/desk review required
  • Strong communication skills including oral presentations and written reports
  • Minimum 5 years of healthcare experience
  • External client facing experience preferred
  • Ability to handle multiple projects at once
  • High degree of self-motivation

Lumeris is an EEO/AA employer M/F/V/D.


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Time Type:

Full time

Keywords: Lumeris, Dallas , Director, Actuarial Services, Other , Dallas, Texas

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