Actuarial Director - Government Programs

Responsibilities

• Serve as the actuarial line of business owner for specified market segment products (Medicaid, Medicare Cost, Medicare Supplement).
• This individual will manage a team responsible for all actuarial activities including budgeting, forecasting, trend analysis and revenue/cost driver identification and evaluation.
• Communicate with executive leadership in an effective and straightforward manner, serving as a thought leader in the management of financial risk and a role model of strategic, proactive communication and collaboration across teams.
• Partner with DHS and their contracted actuaries to influence rate adequacy, assess financial implications of proposed methodologies, and advocate for accurate reflection of risk, trends, and program changes to ensure sustainable and compliant Medicaid reimbursement.
• Collaborate with underwriting, product, marketing and sales by making recommendations for amending or developing products, product pricing and processes to maintain product viability and financial soundness while delivering strategic growth and managing risk. Serve as an advocate for innovation.
• Oversee Managers who serve as the primary contacts with State and Federal regulators for rate and annual filings ensuring timeliness, acceptance by regulators and appropriate loss ratios for regulatory and corporate requirements for solvency, profitability and compliance.
• Stay abreast of regulatory changes, ensuring all responsibilities are addressed, as well as providing thought leadership on how best to adjust strategy in light of regulatory changes.
• Adeptly navigate communication of complex actuarial and/or accounting concepts to non-technical audiences, ensuring enterprise leadership is informed of current and forecasted business results and underlying risks.
• Maintain a strong understanding of how actuarial judgment applied in valuation processes drives the enterprise's narrative of results and actively balance the need for conservatism with timely messaging of departures from expected results.
• Provide insightful research, analysis and interpretation of actuarial and statistical data, providing strategic insights to drive decision making within the department, with other teams and Executive business leaders across the enterprise.
• Develop new tools, based on predictive modeling and machine learning, to refine and modernize current actuarial models and methods. Lead team in transformation into cloud-based data configuration.
• Personally model BCBSMN's enterprise values and serve as a role model of strong people leadership skills both within and outside of the Actuarial department.
• Required Skills and Experience
• Accepting this position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment.
• 10+ years of experience in the areas of actuarial, finance or related field, including experience in managed care. All re

Benefits

Additional Information

About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have BlueCross BlueShield of Minnesota is seeking a strategic actuarial leader to oversee its Medicaid and Medicare Cost/Supplement teams. This role is accountable for the product lifecycles of these products -including DHS Medicaid managed care rate negotiations, pricing, rate filing, forecasting, and financial analyses. The Director will provide leadership, guidance, and motivation to the actuarial team while partnering closely with cross‑functional areas such as product, legal, marketing, finance, regulatory affairs, data and analytics, enterprise risk adjustment, and provider networks. Success in this position requires strong executive presence, proven people leadership, and the ability to adapt to the fast‑paced and evolving health insurance landscape. Ideal candidates have deep Medicaid Managed Care expertise, more than five years of people‑leadership experience, strong actuarial judgment, and a blend of technical proficiency and strategic leadership orientation.

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