Director, Actuarial Services

4 weeks ago

Rancho Cucamonga, United States Inland Empire Health Plan Full time

Overview:

What you can expect

Find joy in serving others with IEHP We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience

This Director is responsible for pricing, performance management, and forecasting for IEHPs 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 IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

  • CalPERS retirement
  • 457(b) option with a contribution match
  • Generous paid time off- vacation, holidays, sick
  • State of the art fitness center on-site
  • Medical Insurance with Dental and Vision
  • Paid life insurance for employees with additional options
  • Short-term, and long-term disability options
  • Pet care insurance
  • Flexible Spending Account Health Care/Childcare
  • Wellness programs that promote a healthy work-life balance
  • Career advancement opportunities and professional development
  • Competitive salary with annual merit increase
  • Team bonus opportunities


Qualifications:

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
  • Bachelors degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is required

Key Qualifications

  • Principles and practices of managed health care industry and strategies
  • Strong understanding of healthcare market landscape
  • Knowledge of accounting/finance concepts
  • Extensive knowledge of MS Excel, Power Point

Start your journey towards a thriving future with IEHP and apply TODAY

Pay Range:
USD $92.79 - USD $127.59 /Hr.

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