JOB SUMMARY

LOCATION: JOHN H. STROGER, JR. HOSPITAL

SHIFT: DAYS

The Director Actuarial Services, Health Plan Services will lead, manage, and coordinate the analytical efforts supporting the rate setting process for CountyCare and Medicare programs to ensure rates are competitive, adequate, and actuarially sound. Serves as a subject matter expert and trusted advisor for health plan leadership. The Director will be responsible performing duties that include, but not limited to, competitive analysis, network analysis, risk adjustment, analyzing trends, actuarial benefit value analysis, etc. and determining the implications on premiums, risk adjustment, and strategic initiatives.

This position is exempt from Career Service under the CCH Personnel Rules.

Typical Duties

• Serves as a subject matter expect overseeing all aspects of the rate setting process.
• Collects and analyzes claim and membership data to estimate potential liabilities.
• Leads and manages the risk adjustment processes and operations
• Develops and projects actuarial models.
• Assists in the development of financial forecasts and projections including the identification of risks and opportunities.
• Provides insight and support for the reinsurance placement process.
• Recognizes and prepares opportunities to enhance analyses and improve efficiencies.
• Develops reserves and submits the documents for the incurred but not reported (IBNR) reporting.
• Reviews and analyzes regulations and potential impacts on the health plan.
• Prepares and submits all required state and regulatory report filings
• Supports medical economics and network pricing analysis by participating in contract negotiations focusing on strategic the rate setting process that will be implemented with Medicaid.
• Assists in the development of the Medicare bid.
• Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
• Attends and participates in meetings, groups discussions, and committees as required.
• Performed other duties as assigned.

VETERAN PREFERENCE

PLEASE READ

When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service

To take advantage of this preference a Veteran must:

• Meet the minimum qualifications for the position.
• Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
• Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable

OR

• A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.

If items are not attached, you will not be eligible for Veteran Preference

VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.

BENEFITS PACKAGE

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan
• Deferred Compensation Program
• Paid Holidays, Vacation, and Sick Time
• You may also qualify for the Public Service Loan Forgiveness Program (PSLF)

For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/

MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.

*Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U. S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview.

*Please note all offers of employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.

*CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.

COOK COUNTY HEALTH & HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER.