Actuary I (Medicare)
Remote | Hybrid
We are currently all mainly working remote. Team will have onsite (Downtown LA HQ office) once a quarter meeting. Candidates must live in California - local enough to Los Angeles to go into the office at minimum once a quarter.
Los Angeles, CA, US
The Actuary I will report to the Director of Actuarial Services. This position will help make estimates for the monthly Financial Statements including, but not limited to, revenue projections and reserves for Incurred But Not Paid claims. Additionally, this position will assist in providing financial contracting guidelines to the Provider Network Management department.
The Actuary I will also routinely participate in the data collection and reporting for the Rate Development Template and other Supplemental Data Requests for the Department of Health Care Services. Furthermore, this position will provide ad hoc financial analyses to external departments for new programs and projects. This Position will provide guidance and mentoring to Actuarial Analysts in the Actuarial department.
Duties
Review premium rates from DHCS and assist in rate negotiations.
Support in monthly financial reporting by setting claims incurred but not paid reserves and other financial estimates.
Certify actuarial estimates for regulators and third parties including DMHC, DHCS, CMS and Covered California.
Analyze data for ad hoc needs including deep data dives and analyses of scenarios for new programs.
Assist Provider Network Management and Legal departments in financial aspects of contract negotiations and amendments.
Project revenue and cost of health care for the routine budgets and forecasts as well as ad hoc analyses.
Collaborate with other departments in work groups for key initiatives and projects.
Present analyses and recommendations to stakeholders, including senior management.
Perform other duties as assigned.
Education Required
Bachelor's Degree in Mathematics or Related Field In lieu of degree, equivalent education and/or experience may be considered.
Required:
At least 5 five to 7 seven years of experience under the supervision of a credentialed (MAAA) Actuary; or, Four years of experience under the supervision of a credentialed (MAAA) Actuary plus successful completion of either one Fellowship Exam or 3 FSA Modules.
Fellowship Exams and FSA modules are administered by the Society of Actuaries.
Required:
Understanding of financial concepts.
Able to create and manage Excel spreadsheets without direction and supervision.
Effective oral, written and interpersonal communication skills.
The level of analysis and results should be more complex and well above the Actuarial Analyst III position.
