Mgr, Actuarial II
Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This role will lead the newly created No Surprises Act (NSA) actuarial team, with responsibility for developing and overseeing actuarial forecasts, reserves, financial analyses, and reporting related to federal NSA activity. The Actuary Manager II will partner across Actuarial, Finance, Operations, Legal, HNS and vendor teams to improve data collection and monitoring processes, assess emerging financial impacts, and communicate key results, risks, and recommendations to stakeholders and senior leadership. What You'll Do
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Lead the actuarial workstream for NSA, including forecasts, reserve estimates, liability monitoring, profitability analyses, and financial impact assessments.
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Partner with Actuarial, Finance, Operations, Legal, HNS, and vendor contacts to gather, validate, and interpret data required for NSA financial analysis and reporting.
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Develop and maintain documentation of NSA data sources, assumptions, methodologies, process flows, and reporting definitions to support consistency and auditability.
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Create recurring reporting packages that summarize NSA inventory trends, liability movements, payment activity, financial impacts, and notable operational developments.
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Identify opportunities to improve data quality, streamline data collection, reduce manual effort, and strengthen ongoing monitoring of NSA activity.
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Integrate NSA inventory, liability, and payment information into actuarial reserving, forecasting, and financial reporting processes.
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Prepare analyses, summaries, and presentation materials that clearly communicate NSA financial results, emerging trends, key risks, and recommended areas of focus.
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Participate in NSA working sessions and stakeholder meetings to understand operational changes, evaluate financial implications, and provide actuarial perspective on strategic initiatives.
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Monitor regulatory, operational, and claims-related developments that may affect NSA financial results and communicate findings to actuarial leadership.
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Support ad hoc analyses and special projects across key actuarial functions, including reserving, pricing, forecasting, and other financial or business needs.
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Lead and support team members by setting priorities, reviewing analytical work, providing coaching, and ensuring timely delivery of high-quality NSA actuarial deliverables.
What You Bring
Education/Experience:
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Bachelors degree required, preferably within Mathematics, Statistics, Actuarial Sciences or a related field.
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Requires 7+ years of Actuarial and/or statistics experience and attainment of Associate level in the Society of Actuaries (ASA).
- Prefers supervisory experience.
- Exposure to NSA highly preferred
Additional licensing, certifications, registrations:
- ASA required
Knowledge:
- Requires expert knowledge of Excel.
- Requires advanced proficiency with SAS.
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Requires trend, actuarial forecast and reserves experience.
- Knowledge of NSA regulations
Skills and Abilities:
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Requires excellent oral and written communication skills.
- Requires strong analytical thinking.
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Requires strong mathematical skill and statistical analysis abilities.
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Requires good judgment and problem-solving skills.
- Requires strong managerial skills.
- Requires strong leadership skills.
Why Horizon?
At Horizo