Director - Risk Sustainability IBU

Can one person make a difference? When you choose  a career at Blue Cross Blue Shield, you can have an impact on Americans nationwide. Join the team that is a leader in healthcare innovation and supports the nation's largest healthcare network, providing coverage to nearly one in three Americans.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of Blue Cross Blue Shield of Michigan 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 /> <ul> <li>Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyles</li> <li>The largest network of doctors and hospitals in the state</li> <li>Lower health care costs</li> <li>Higher quality health care</li> <li>Award-winning diversity practices</li> <li>Grants and programs that promote better health throughout Michigan</li> </ul> <strong>Mission: </strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><strong><a href="https://www.glassdoor.com/Overview/Working-at-Blue-Cross-Blue-Shield-of-Michigan-EI_IE5786.11,45.htm" target="_blank">Click here</a></strong> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades. http://www.bcbsm.com

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Experienced

Overview: <strong>This position will be focused on understanding and managing the drivers of risk that impact achievement of a sustainable and balanced risk pool within and across the multiple functions in BCBSM&rsquo;s matrix organization.</strong>
Responsibilities: Identify the areas of cross-subsidization within all aspects of IBU business. Ensure that unintentional cross-subsidization has a mitigation plan. Ensure cross functional alignment in the establishment and implementation of IBU policies and practices, that are within regulatory, corporate and compliance guidelines. Identify and implement retention management tools and interventions across product, price, customer service and other functions. Work with the matrix partners to create alignment on risk related issues pertaining to IBU. Consult and confirm with VP IBU as appropriate to establish policy and ensure integration for risk and P&amp;L have vertical and horizontal alignment. Act as point of integration for risk and P&amp;L issues at the operating management level. Create and manage a risk reporting tool that provides early detection of problems/opportunities and report actual performance against expected/targeted goals. Leverage on-going risk management assessment tools and ensure that capabilities are developed related to IBU. Recommend business driven market pricing, in collaboration with relevant functional leaders.
Requirements: <ul> <li>Bachelor's Degree in related field required.&nbsp; Master's Degree in related field preferred.&nbsp;</li> <li>Minimum of seven (7) years of experience in actuarial, underwriting or risk management function in a health insurance company.</li> <li>Strong understanding of healthcare reform and its implications to IBU is required.</li> <li>Must have a strong understanding of the individual insurance work flows across functions and points of tension.&nbsp;</li> <li>Must have demonstrated skills in project management which include issue identification, documentation, and status reporting.</li> <li>Strong business and risk management skills with in-depth understanding of the drivers of risk and profitability.</li> <li>Ability to influence, coordinate and collaborate aligning the efforts of a matrix organization.</li> <li>Excellent analytical, organizational, problem resolution, verbal and written communication skills with the ability to conduct presentations required.</li> <li>Ability to work effectively in a team environment and closely with all key divisional staff.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul>