Job Description - Vice President, Actuarial and Underwriting
Vice President, Actuarial and Underwriting - ( 3124387 )
A career at AllWays Health Partners is you in every way!
Inspired by our affiliation with Partners HealthCare, our promise
as a people-first organization starts with our employees. Get
inspired to bring your unique talents to our diverse community and
challenge the health care industry status quo with innovative
programs that put people first. Our perks include a competitive
benefits package, access to world-class doctors, and more.
Under the broad direction of the Deputy Chief Financial Officer
and Chief Actuary, the Vice President, Actuarial and Underwriting
has overall organizational responsibility for the Actuarial and
Underwriting functions of the organization including development,
communication, and implementation of the actuarial and underwriting
strategies and practices.
The Vice President, Actuarial and Underwriting is responsible
for setting reserves, developing commercial premium rates and
methodology and analyzing medical trends for AllWays Health
Partners. They will be responsible for developing monthly
outstanding claim liability reserves for all lines of business and
developing and supervising the actuarial and underwriting
functions. The Vice President, Actuarial and Underwriting will be
responsible for developing and maintaining rate formulas and models
for all necessary rate filings for the commercial line of business,
as well as underwriting guidelines, models, and factors for large
group rating. They will collaborate with Sales and Marketing on the
development of rating and underwriting policies to meet financial
and sales goals. They will be a key player in the development and
expansion of the commercial line of business. In addition they will
be responsible for analyzing underlying cost and utilization trends
for the commercial line of business and the plan as a whole, and
assessing the actuarial soundness of Medicaid rates.
• Directs the calculation of risk and pricing for products and
services provided by the health plan.
• Works closely with Strategy and Marketing, Finance, Medical
Economics, Product, Sales and other actuarial and underwriting
• Develops rate formulas, models, and underwriting guidelines
for the Commercial line of business.
• Uses rate formulas, models, and underwriting guidelines to
calculate rates for Commercial accounts.
• Manages Commercial account profitability through quarterly
reporting, monitoring of actual vs. budgeted rates, and other
• Files Commercial rates in accordance with state
• Assists Sales in delivering rates to Commercial accounts as
• Provides claim experience to Commercial accounts as
• Calculates unpaid claim liabilities monthly and other accruals
to ensure accuracy of financial statements.
• Participates in MassHealth rate negotiations and other
financial activities as needed.
• Assists in the evaluation of reinsurance programs and other
corporate insurance as needed.
• Assists in the development of new products as needed.
• Manages and provides appropriate Actuarial support to
corporate initiatives and projects.
• Serves as the Partners HealthCare subject matter expert on
premium revenue, insurance risk, and trend forecasting
• Developing corporate wide best practices on forecasting and
monitoring medical trend.
• Developing best practice and practical provider risk
• Developing a methodology to have consistent treatment of
reserves and financial forecasts across Partners HealthCare by
understanding correlations between the insurance and provider
• Understanding the enterprise risk of Partners HealthCare
including but not limited to insurance division and provider side
• Working with organizations to understand the difference
between system wide optimization and optimization for individual
Partners HealthCare entities.
• Anticipates and meets, or exceeds, internal and/or external
customer expectations and requirements; establishes and maintains
effective relationships with customers and gains their trust and
• Informs, engages, inspires, motivates, and actively listens to
• Identifies and develops processes and aligns resources to
accomplish key objectives; clearly conveys and assigns
accountability for objectives, deadlines, and expectations.
• Sets clear goals and objectives, uses metrics to measure
performance, and hold employees accountable.
• Ensures diversity, equity, and inclusion are integrated as a
Department Specific Functions:
• Other duties as assigned with or without accommodation.
Working Conditions and Physical Effort:
• Work is normally performed in a typical office work
Knowledge and Education: Required: • Undergraduate Degree or the
equivalent combination of training and experience • FSA and MAAA
required Preferred/Desired: • Masters preferred • Expert in use of
spreadsheets and knowledge of databases in general
Experience: Required: • 10 plus years of work experience with
several years of experience in managed healthcare required. • At
least 3 years of experience with premium rate and benefit pricing
methodologies. • Demonstrated forecasting and medical trend
experience. • Must meet Qualification Standards for Actuaries
Issuing Statements of Actuarial Opinion in the United States (US
Qualification Standard) Skills/Competencies: • Demonstrate AllWays
Health Partners’ core brand principles of always listening,
challenging conventions, and providing value. • Bring fresh and
innovative ideas forward by listening to and working with employees
and the people we serve. • Strong, demonstrated track record of an
ability to execute on time, on budget, and on scope. • Strong
aptitude for technology-based solutions. • Current in healthcare
and health plan trends. • Demonstrated forward, visionary thinking;
ability to see “what is” and envision “what could be.” • Ability to
develop, introduce, defend, and gain support for a new ideas and
approachess. • Excellent leadership skills and leadership track
record. • Ability to translate and communicate complex topics in a
variety of forums, tailoring communications to effectively fit and
influence the targeted audience. • Strong verbal, active listening,
and written communication skills. • Demonstrated ability to apply a
variety of strategic frameworks to analyze problems and to guide
and develop solutions. • Ability to challenge the status quo and
drive innovative thinking and the capability to successfully
implement strategy. • Excellent interpersonal skills, including the
ability to influence others at all levels of an organization. •
Strong EQ; exercises self-awareness; monitors impact on others; is
receptive to and seeks out feedback; uses self-discipline to adjust
to feedback. EEO Statement Our promise as a people-first
organization starts with our employees. AllWays Health Partners is
committed to diversity, equity, and inclusion in our workforce,
internal culture, and investments. As an equal opportunity
employer, AllWays Health Partners recognizes the power of a diverse
community and encourages applications from individuals with varied
experiences, perspectives, and backgrounds.
Primary Location MA-Somerville-Allways Health Partners at
Work Locations Allways Health Partners at Assembly Row
Organization AllWays Health Partners
Standard Hours 40
Shift Day Job
Employee Status Regular