Manager, Individual Market - Analytics/Financial Performance

<p>With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.</p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

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Competitive Total Compensation Package

Overview: <div><span style="font-family: arial;"><strong><span style="font-size: small;">The Individual Business Unit (IBU) is seeking an experienced and highly motivated manager to lead the Finance and Actuarial team. The ideal candidate will have a well-rounded mix of actuarial and financial experience and will be able to combine strong analytical and data modeling skills with a high degree of business acumen to drive solutions and develop insights. This role works closely with IBU partners across the organization from Actuarial, Finance, Product, Sales and Marketing, Operations, Corporate Strategy/Planning, HCV/WCM, Tessellate and ONHR and should have a proven track record of leveraging business relationships to drive cross-functional collaboration. Strong communications skills are a must including the ability to effectively communicate financial performance and strategic imperatives through PowerPoint presentations, dashboards, and reports to a diverse range of audiences including senior leadership.</span></strong></span></div>
Responsibilities: <p><span style="font-family: arial;"><strong><span style="font-size: small;">The IBU Finance and Actuarial Manager will be responsible for the following:</span></strong></span></p> <ul> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Direct a cross-functional team to develop IBU&rsquo;s multi-year pricing strategy for each annual product development cycle to ensure IBU is on a path to achieve the segment&rsquo;s long-term membership and margin targets.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Balance tradeoffs between membership and margin in setting pricing for IBU&rsquo;s entire product portfolio. The ability to think strategically and with an eye to the competitive landscape in setting pricing relativities, area factors, network relativities and other pricing factors is key to success in the role.<br /></span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Forecast IBU membership and individual market size for utilization in setting corporate targets, pricing IBU&rsquo;s products, developing business plans, allocating resources, and for setting IBU&rsquo;s budget.&nbsp; Work with Actuarial and Finance in forecasting IBU&rsquo;s financial results through the Capital Plan process.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Develop business cases and perform cost/benefit financial analysis related to IBU business decisions and emerging regulatory issues.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Lead an Advanced Analytics team that is responsible for data analysis and predictive modeling. Partner with stakeholders on predictive modeling requests both within the segment and within the broader organization, as well as working with external vendors.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Manage the relationship with IBU&rsquo;s internal Informatics team to ensure IBU has access to necessary membership, claims, profitability, and other data needed for analytical purposes.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Use a data and analytically driven approach to monitor results vs. targets, identify problems quickly, and develop recommended solutions.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Develop actionable insights and drive monthly, quarterly, and &ldquo;real-time&rdquo; reporting during the open enrollment period (OEP) related to IBU performance from a membership and margin perspective.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Review and work with business partners to take the detailed information and develop simple and concise explanations of financial changes and implications.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Create executive-level presentations related to topics such as competitive pricing, IBU&rsquo;s pricing strategy, and IBU&rsquo;s financial performance.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Work with Tessellate, IBU&rsquo;s risk adjustment vendor, to manage the risk adjustment submission process and drive revenue enhancement initiatives.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Support the relationship with Health Care Value (HCV) and Wellness Care Management (WCM) to implement, monitor and optimize benefit cost savings initiatives and network solutions for the individual market.</span></strong></span></li> <li><span style="font-family: arial;"><strong><span style="font-size: small;">Partner with the Financial Performance and Management (FPM) team to track and monitor IBU financial performance and develop insights that support senior leadership in running the business and producing actionable results.</span></strong></span></li> <li><span style="font-size: small;"><strong>Other duties may be assigned.</strong></span></li> </ul>
Requirements: <div id="requisitionDescriptionInterface.ID1574.row1" class="inlinepanel" title=""><span class="subtitle">Qualifications</span></div> <p><span style="font-size: small;"><strong><u>DEPARTMENT REQUIREMENTS</u></strong></span></p> <ul type="disc"> <li> <p><span style="font-size: small;">Bachelor's Degree in related field required. Degrees in actuarial science, finance, or data science are highly preferred.</span></p> </li> <li> <p><span style="font-size: small;">Five (5) years experience in related field including analytical experience in a leadership role.</span></p> </li> <li> <p><span style="font-size: small;">Five (5) years experience in strategic roles driving financial and/or actuarial results.</span></p> </li> <li> <p><span style="font-size: small;">Ability to lead cross-functional teams including Actuarial, Finance, Product, Sales, Marketing, Corporate Strategy/Planning, Office of National Health Reform (ONHR), Tessellate/Enterprise Risk Adjustment, Health Care Value (HCV) and Wellness Care Management (WCM) teams</span></p> </li> <li> <p><span style="font-size: small;">Strong management skills capable of motivating, managing, and developing a team with a wide breadth of skillsets required</span></p> </li> <li> <p><span style="font-size: small;">Ability to conduct cost benefit analysis and forecast future impacts to the business based on changing market dynamics</span></p> </li> <li> <p><span style="font-size: small;">Excellent problem solving, analytical, project and process skills required</span></p> </li> <li> <p><span style="font-size: small;">Strong decision analysis capabilities</span></p> </li> <li> <p><span style="font-size: small;">Advanced skills with the Microsoft Office suite of products, especially Excel, Access, PowerPoint and Word</span></p> </li> <li> <p><span style="font-size: small;">Working knowledge of SAS Enterprise Guide and Visual Analytics is preferred</span></p> </li> <li> <p><span style="font-size: small;">Ability to work with large datasets and obtain data from various SQL server or enterprise data stores</span></p> </li> <li> <p><span style="font-size: small;">Ability to think strategically and contemplate how solutions will impact not just the segment, but also the enterprise as a whole</span></p> </li> <li> <p><span style="font-size: small;">Working knowledge of individual health care reform and existing Affordable Care Act (ACA) regulation preferred</span></p> </li> <li> <p><span style="font-size: small;">Experience with BCBSM internal data stores such as EDW, CADE, MRDM, and FACETS strongly preferred</span></p> </li> <li> <p><span style="font-size: small;">Proven experience in developing analytical and financial models with applied business outcomes such as life-time value models, regression/time-series models, clustering techniques, and membership/market forecasting models.</span></p> </li> <li> <p><span style="font-size: small;">Development of complex models to project membership across many dimensions</span></p> </li> <li> <p><span style="font-size: small;">Excellent problem solving, analytical, project and process skills required</span></p> </li> <li> <p><span style="font-size: small;">Ability to understand and apply statistical inference</span></p> </li> <li> <p><span style="font-size: small;">Strong consulting, leadership and negotiation skills</span></p> </li> <li> <p><span style="font-size: small;">Strong oral, written and communication skills</span></p> </li> <li> <p><span style="font-size: small;">Highly self-driven and self-motivated&nbsp;</span></p> </li> <li> <p><span style="font-size: small;">Ability to work under general direction.</span></p> </li> <li> <p><span style="font-size: small;">Ability to work effectively in a team environment.</span></p> </li> <li> <p><span style="font-size: small;">Extensive knowledge of corporate organizational structure, including functional responsibilities.</span></p> </li> <li> <p><span style="font-size: small;">Comprehensive understanding of all BCBSM's products, programs, administrative policies and procedures.</span></p> </li> <li> <p><span style="font-size: small;">Highly developed interpersonal skills.</span></p> </li> <li> <p><span style="font-size: small;">Other related skills and/or abilities may be required to perform this job.</span></p> </li> </ul>