VP Reserving Forecasting & Trend Analytics

Company :

Job Description : 

JOB SUMMARY

This critical senior leadership role guides a high-performing team of actuarial and analytics professionals, driving strategic, tactical, and operational excellence in claims reserving, financial forecasting, and sophisticated trend analytics. This position plays a pivotal role in shaping Highmark's financial stability and strategic direction by providing accurate insights and proactive guidance to senior leadership across the enterprise.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, and manage the day-to-day operations of the team; develop and implement policies and programs as necessary; manage to assigned budgets. 

• Strategic Actuarial & Financial Leadership:

  • Serve as a trusted advisor to Senior Management and cross-functional teams, proactively identifying opportunities and advocating for strategic and tactical changes and best practices that align with Highmark's enterprise-wide goals.

  • Provide expert consultative services, translating complex actuarial and financial data into actionable insights for strategic decision-making.                                                              

• Reserving & Compliance Oversight:

  • Drive continuous improvement in valuation practices, ensuring robustness and accuracy.

  • Direct and oversee the development and delivery of exceptional actuarial work products, ensuring full compliance with all professional, legal, and regulatory standards, including Actuarial Standards of Practice (ASOPs), state and federal regulations, and accounting principles.

  • ⁠Lead the calculation and oversight of all statutory and GAAP reserves, ensuring accuracy and compliance with actuarial standards and regulatory requirements.

  • Direct analyses to support the preparation and submission of actuarial opinions, memoranda, and other financial reporting to regulatory bodies.

  • Lead and support internal and external audits by providing comprehensive documentation and clear explanations of valuation processes, methodologies, and assumptions.                                      

• Financial Forecasting & Performance Management:

  • Lead the comprehensive financial forecasting process, including the annual Fall Plan and multiple bottom-up Reforecasts (Spring and Summer), collaborating closely with the FP&A team.

  • Develop and deliver monthly financial outlooks based on dynamic claims information, providing timely updates and strategic implications to key stakeholders.

  • Establish robust processes for monitoring actual claims and revenue performance against forecasts, conducting deep-dive variance analyses to understand underlying drivers and continuously refine projection methodologies for enhanced accuracy.

• Advanced Trend Analytics & Insights:

  • Lead and empower the Trend Analytics team to identify, analyze, and interpret key trend drivers, developing early indicators that inform medical economics strategies and support proactive intervention.

  • Translate complex data into clear, concise, and actionable trend insights that guide strategic business decisions and cost management initiatives.                                                                 

• Talent Leadership & Development:

  • Foster a high-performance, inclusive, and mutually supportive work environment characterized by respect, continuous learning, and innovation.

  • Inspire and motivate a diverse team of professionals, setting clear direction and creating an atmosphere of trust that encourages diverse perspectives and promotes career growth.

  • Provide exemplary coaching, mentorship, and constructive feedback throughout the year and during annual performance appraisals, supporting individual career progression and skill development.

  • Champion team development through corporate and departmental initiatives, identifying and creating stretch assignments and growth opportunities to challenge and advance team competency.

  • Develop and implement an effective succession plan for key departmental positions, ensuring talent readiness and continuity.

  • Manage departmental cost centers, developing annual budgets and monitoring expenses to ensure efficient and effective utilization of Highmark resources.                                                                         

• Other duties as assigned or requested.                                                                       

EXPERIENCE

Required

• Minimum of 7 years of progressive experience in the healthcare industry, specifically within actuarial, financial forecasting, or trend analytics functions.

• Minimum of 5 years of demonstrated leadership experience managing and developing high-performing teams

Preferred

• 10+ years of comprehensive actuarial experience, including at least 7 years in the healthcare industry.

SKILLS

• Exceptional Leadership: Proven ability to inspire, motivate, and develop high-performing teams in a dynamic, matrixed environment to achieve superior results quickly.

• Strategic Acumen: Deep understanding of industry and market trends, with the ability to translate insights into long-term strategic initiatives and champion new approaches effectively.

• Influential Communication: Superior communication and persuasion skills, capable of engaging senior stakeholders, building consensus, and driving commitment and action on complex strategic imperatives.

• Analytical Rigor: Strong analytical and problem-solving capabilities, with an unwavering commitment to data accuracy and insightful interpretation.

• Technical Proficiency: Extensive proficiency in the technical aspects of actuarial work, including advanced modeling and statistical techniques.  

• Business Acumen: Comprehensive understanding of healthcare business operations, financial drivers, and regulatory landscapes.

EDUCATION

Required

• Bachelor’s degree in Mathematics, Economics, Actuarial Science, or a closely related quantitative field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.   

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• Designation as an Associate of the Society of Actuaries (ASA) and Membership in the American Academy of Actuaries (MAAA) is required.

Preferred

• Designation as a Fellow of the Society of Actuaries (FSA)

Language (Other than English):

• None

Travel Required:

• 25% - 50%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

• Office-Based or Remote Position

Physical work site required

• Constantly

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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