Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This is a senior level manager position within the Actuarial department. Performing analysis around the large employer commercial market to ensure long-term growth, profitability and compliance with state mandates & regulations. Requires partnership and cooperation with Sales, Underwriting and Finance to achieve organizational goals.What You'll Do
Monitor the financial performance of the large employer fully insured markets, including Midsize and Public
Lead actuarial studies to refresh rating methodology and factors and manage the implementation of updates within the Stepwise rating engine
Monitor and evaluate discount metrics for the large employer self-insured markets, identifying data quality issues and developing strategies to improve performance and accuracy
Conduct pricing studies for new state mandates or other non-standard underwriting requests
Oversee Mental Health Parity testing & compliance
Forecast and manage performance guarantees for self-insured employers including the State Health Benefit Plan
What You Bring
Requires a Bachelor's degree, preferably within Mathematics, Statistics, Actuarial Sciences or a related field.
Requires 8+ years of Actuarial and/or statistics experience.
Prefers at least 3 years supervisory experience.
Requires the attainment of Associate level in the Society of Actuaries (ASA).
Requires expert knowledge of Excel.
Prefers working knowledge of Access or other database application.
Experience with SAS, Snowflake, SQL or other programming language a plus.
Prefers experience with UDS discount metrics
Prefers experience with Stepwise rating engine
Requires strong working knowledge of data analysis and Actuarial principles
Requires strong working knowledge of data analysis and Actuarial principles.
Requires in depth knowledge of the healthcare industry.
Requires excellent oral and written communication skills.
Requires strong analytical thinking.
Requires strong mathematical skill and statistical analysis abilities.
Requires good judgment and problem-solving skills.
Requires strong managerial skills.
Requires strong leadership skills.
Why Horizon?
At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!
Salary Range:
$138,400 - $188,895This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Disclaimer:
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.