Actuarial Services Director jobs in California

Education & Experience

• Minimum ten (10) years of actuarial experience in Health Care industry
• Proven strategy actuarial or analytic leadership experience in working with cross-functional teams
• Data analysis experience in a healthcare setting
• Five (5) years of managing experience is required
• Bachelor’s degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is required
• Hybrid role. California resident or those looking to relocate to the Inland Empire encouraged to apply

This Director is responsible for pricing, performance management, and forecasting for IEHP’s Medicare and Commercial (i.e., Covered CA) line of business. This includes, but not limited to, the development of product analytics to define and measure the financial performance and providing actuarial support to other business units for the two lines of business. This position collaborates with other IEHP business units in planning and developing strategies to maximize the financial performance. This leader will oversee credential actuaries and actuarial team members to support the department functions, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.

Major Functions (Duties and Responsibilities)

1. Lead development of pricing, experience analysis, and financial forecast modeling for all lines of business.

2. Develop product analytics to define and measure financial performance.

3. Lead actuarial function on Medi-Cal Rate Development Template (RDT) support and other state date requests.

4. Perform Medi-Cal revenue rate analysis and serve as Subject Matter Expert (SME) for Medi-Cal rate advocacy.

5. Oversees development for Medicare bids, regulatory rate filings and other required regulatory submissions for the assigned lines of business.

6. Collaborate with IEHP business units in planning and developing strategies to maximize the financial performance.

7. Communicate clearly and present appropriate level of information to senior leaders.

8. Research, evaluate and analyze the market landscape for the assigned lines of business.

9. Lead a team of analysts to ensure cohesive team culture and effective collaboration with other business units.

10. Manage the respective actuarial service unit including recruiting, training, and coaching Team Members.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.