Actuarial Services Director directs the activities of an organization's actuarial function. Oversees the analysis and evaluation of potential risks to determine the financial impacts of new or existing insurance plans. Being an Actuarial Services Director develops policies, procedures, and formulas to guide statistical analysis and actuarial research and evaluate the likelihood and financial impact of various risks. Designs processes and guidelines to ensure regulatory compliance of products and financial operations. Additionally, Actuarial Services Director leads the design and development of insurance products by evaluating and approving insurance rates, premium levels, and rating systems and structures. Oversees the preparation of actuarial reports, financial statements, and regulatory filings and develops financial budgets, forecasts, and other financial projections. Researches and selects major rating assumptions to support accurate statistical analysis and evaluates the effectiveness of existing formulas. Evaluates product performance against established profitability targets and recommends modifications. Applies knowledge of mathematics, probability, statistics, principles of finance and business to calculations in life, health, social, and casualty insurance, annuities, and pensions. Requires a bachelor's degree. May require Associate of Society of Actuaries (ASA). May require Fellow of Society of Actuaries (FSA). Typically reports to senior management. The Actuarial Services Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be an Actuarial Services Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
SCOPE OF POSITION:
Responsible for the efficient and effective development, production, and management of all aspects of AFMC’s clinical case review in Medicare, Medicaid, and private review contracts as well as referrals by outside agencies. Develop relationships and promotes mutually beneficial partnerships with clients, key stakeholders, constituents, provider groups, other healthcare organizations and the community at large. Market the programs and services of AFMC to existing and new stakeholders. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence Accountability, Respect and Teamwork.
ESSENTIAL JOB FUNCTIONS:
KNOWLEDGE, SKILLS, AND ABILITIES:
Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write ability to communicate with personnel and ability to remain calm under stress. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.
EDUCATION:
Required: Bachelor’s degree in nursing and currently licensed as a Registered Nurse in the state of Arkansas, without restrictions.
Desirable: Master’s degree in nursing, public health, healthcare administration, business administration or statistics
EXPERIENCE:
Required: Six (6) years’ experience in nursing, Four (4) years leadership experience. Five (5) years utilization review, quality assurance, coding or RHIT/RHIA hospital experience, experience and knowledge of Medicare, Medicaid, and other major managed healthcare programs
Desirable: Experience in a QIO, non-profit and/or professional services healthcare setting
INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)
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