Role Summary

HIGHLIGHTS

Manager-level health actuarial role at L.A. Care Health Plan in Los Angeles. You will lead actuarial services including monthly financial reporting, regulatory filings (DHCS/CMS/Covered CA), risk adjustment model oversight, and staff management. Role requires strong experience in managed care, risk adjustment, and financial projections.

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and actuarial analyses for a large health plan
Oversee risk adjustment models (e.g., CMS-HCC, RxHCC, CDPS+Rx) and risk-score analysis
Lead a team of actuarial staff; hiring, coaching, performance management
Support regulatory filings to DHCS, CMS, and Covered CA
Role based in Los Angeles; requires 7+ years in health actuarial and management experience

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Four or more years of supervisory or management experience
Experience with risk adjustment models and provider payment methodologies
Thorough understanding of health care cost structures and capitation/shared risk arrangements

KEY REQUIREMENTS

At least 7 years of actuarial experience in health insurance or managed care
At least 4 years of supervisory or management experience
ASA and MAAA or at least 4 associate exams passed required
Proficiency with SQL, SAS, R, Python or Power BI and advanced Excel modeling
Experience with risk adjustment models and provider payment methodologies

TECH STACK

Power_BI
Excel
PowerPoint

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Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and actuarial analyses for a large health plan
Oversee risk adjustment models (e.g., CMS-HCC, RxHCC, CDPS+Rx) and risk-score analysis
Lead a team of actuarial staff; hiring, coaching, performance management
Support regulatory filings to DHCS, CMS, and Covered CA
Role based in Los Angeles; requires 7+ years in health actuarial and management experience

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Four or more years of supervisory or management experience
Experience with risk adjustment models and provider payment methodologies
Thorough understanding of health care cost structures and capitation/shared risk arrangements

KEY REQUIREMENTS

At least 7 years of actuarial experience in health insurance or managed care
At least 4 years of supervisory or management experience
ASA and MAAA or at least 4 associate exams passed required
Proficiency with SQL, SAS, R, Python or Power BI and advanced Excel modeling
Experience with risk adjustment models and provider payment methodologies

TECH STACK

Power_BI
Excel
PowerPoint

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and actuarial analyses for a large health plan
Oversee risk adjustment models (e.g., CMS-HCC, RxHCC, CDPS+Rx) and risk-score analysis
Lead a team of actuarial staff; hiring, coaching, performance management
Support regulatory filings to DHCS, CMS, and Covered CA
Role based in Los Angeles; requires 7+ years in health actuarial and management experience

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Four or more years of supervisory or management experience
Experience with risk adjustment models and provider payment methodologies
Thorough understanding of health care cost structures and capitation/shared risk arrangements