Responsible for the overall management and oversight of staff
Monthly financial reporting and related analysis and reporting
Assistance with the submission of health care experience reports and financial regulatory filings
Review and analysis of DHCS, CMS, and/or Covered CA payment rates to L.A. Care
Work with risk adjustment models for all lines of business
Manage risk score data analysis and reporting
Review rates and other at-risk payments from DHCS, CMS, Covered CA
Manage staff, including monitoring performance, training, and encouraging process enhancements
Manage complex projects, engaging and updating key stakeholders, developing timelines
Responsible for reporting, budgeting, and policy implementation

Requirements

Bachelor's Degree in Mathematics or Related Field
Master's Degree in Mathematics or Related Field (Preferred)
At least 7 years of actuarial experience in health insurance or managed care environment
At least 4 years of leading staff or supervisor/management experience
Experience leading teams, projects, initiatives, or cross-functional groups
Experience with risk adjustment models (CDPS+Rx, CMS-HCC, RxHCC, etc.) and provider payment methodologies (Preferred)
Familiarity with probability theory, calculations and applicability to managing financial risk
Proficient with SQL, SAS, R, Python, or Power BI; advanced Excel modeling required
Attainment of Associateship in the Society of Actuaries (ASA) and Membership in the American Academy of Actuaries (MAAA) or at least 4 Associate exams passed (Required)

Benefits

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

actuarial experiencerisk adjustment modelsfinancial reportingdata analysisbudgetingpolicy implementationprobability theoryadvanced Excel modelingSQLSAS

Soft Skills

staff managementperformance monitoringtrainingprocess enhancementsproject managementstakeholder engagementteam leadershipcross-functional collaboration

Certifications

Associateship in the Society of Actuaries (ASA)Membership in the American Academy of Actuaries (MAAA)