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Director, Actuarial Services (Director IV)

CalOptima HealthUnited States3mo ago
OnsiteMedicaidReserving & ValuationPricing & RatingBusiness Intelligence & Reporting

Role Summary

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HIGHLIGHTS

Director-level health actuarial role at a California public health plan. You will lead Actuarial Services within the Financial Analysis team, owning IBNR reserving, Medi‑Cal rate development, capitation pricing and risk-adjustment processes. The role is full-time, full-office in California and requires leadership of a team and interaction with senior finance leadership.

JOB DESCRIPTION SUMMARY

  • Lead Actuarial Services and manage a team within the Financial Analysis function
  • Own IBNR reserving, Medi‑Cal rate development (RDT) and provider capitation pricing
  • Direct CDPS risk adjustment and develop actuarial studies and analytic tools
  • Build and maintain dashboards/report suites for senior management
  • Full‑office California role; ASA required and FSA preferred

DOMAIN EXPERTISE

  • health plan actuarial experience
  • IBNR reserving for health lines
  • Medi‑Cal rate development (RDT)
  • provider capitation rate development
  • CDPS risk adjustment process

KEY REQUIREMENTS

  • Bachelor's degree plus 7+ years actuarial/analytics experience in health care
  • 3+ years finance leadership at a health plan with direct supervisory responsibility
  • Associate of the Society of Actuaries (ASA) required
  • Proven experience producing IBNR reserve estimates and Medi‑Cal rate development
  • Ability to design dashboards and analytics (Tableau or Power BI experience noted)

TECH STACK

  • Excel
  • Power_BI
  • Tableau
  • PowerPoint