Actuary Principal

at  CalOptima

CALOPTIMA

CalOptima Health is seeking a highly motivated an experienced Actuary Principal to join our team. The Actuary Principal is a key member of the Financial Analysis department. The incumbent is responsible for rendering actuarial analysis and pro-active recommendations to management on both tactical and strategic nature. In addition, the incumbent collaborates with members from business units across the organization and provide actuarial services that enable actionable insights to operations, and to facilitate solutions that allow for informed decision making.

MINIMUM QUALIFICATIONS:

• Bachelor’s degree in health care economics/planning, business, mathematics or related field required.
• 6 years of actuarial experience in health insurance experience required.
• 5 years of actuarial experience with Medi-Cal managed care required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

PREFERRED QUALIFICATIONS:

• Master’s degree in health care economics/planning, business, mathematics or related field.
• 3 years of actuarial experience with Medicare required.

KNOWLEDGE & ABILITIES:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health’s leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

PHYSICAL REQUIREMENTS (WITH OR WITHOUT ACCOMMODATIONS):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

THE SELECTION PROCESS MAY INCLUDE, BUT IS NOT LIMITED TO, A SKILLS ASSESSMENT, PHONE SCREEN AND INTERVIEW.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.
Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
To apply, please visit: https://jobs.caloptima.org/jobs/actuary-principal-505-city-parkway-california-united-states
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• 80% - Financial Analysis Support
• Leads actuarial efforts that affect new and existing business and determines the impact of various actions.
• Provides design and oversight of complex actuarial projects.
• Provides analytic support necessary to assist with the planning and development of strategic initiatives in line with the company’s mission, vision and values.
• Collaborates with other business units across the organization to develop cost benefit analysis for strategic initiatives.
• Provides support for the development of Incurred But Not Reported Reserves (IBNR) estimates, state rate development templates, Medicare bids, medical costs and trends, capitation rates and Chronic Illness and Disability Payment System (CDPS) risk scores.
• Supports management with budgeting and forecasting duties, as needed.
• Serves as primary liaison with external actuarial services and support.Assists in evaluation of decision support and analysis tools, as well as improvements to the Data Warehouse.
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• 15% - Administrative Support

• Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Assists with recruiting, training and coaching team members.
• Maintains deep knowledge and insight of competitive and regulatory landscape, along with research, on various aspects of health care industry.
• Assists in the formulation of policies and procedures.Understands and interprets policies, procedures and regulations.
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• 5% - Completes other projects and duties as assigned.