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Actuarial Analyst Sr

CalOptima HealthUnited States4mo ago
HybridNot SpecifiedReserving & ValuationPricing & RatingBusiness Intelligence & Reporting

Role Summary

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HIGHLIGHTS

Senior health plan actuarial analyst supporting reserving, rate development, and risk-adjusted capitation analysis for a managed care Financial Analysis team in California. Primary responsibilities include monthly IBNR reserve estimates, CDPS risk score analysis, enrollment and claims reporting, and designing data warehouse reports.

JOB DESCRIPTION SUMMARY

  • Perform monthly IBNR reserve estimates and related reserving analysis
  • Analyze CDPS risk scores and financial impact on risk-adjusted capitation
  • Prepare annual rate development templates and bids for lines of business
  • Design reports from the data warehouse and generate claims/utilization reports
  • Partial telework eligible in California; position based in California (505 City Parkway West)

DOMAIN EXPERTISE

  • IBNR reserving and reserve estimation
  • Risk-adjusted capitation and CDPS risk score analysis
  • Rate development and bid preparation
  • Enrollment, claims, and utilization reporting
  • Managed health care financial modeling

KEY REQUIREMENTS

  • Bachelor's degree in actuarial science, math, finance or related (required)
  • Minimum 2 years of actuarial experience
  • At least 2 actuarial exams passed
  • Experience preparing IBNR reserves and claims/utilization analysis
  • Eligible for Partial Telework (California only) — must be located/authorized in CA

TECH STACK

  • Excel
  • PowerPoint