Role Summary

HIGHLIGHTS

Manager-level health actuarial role at L.A. Care in Los Angeles. You will lead actuarial services for monthly financial reporting, regulatory filings (DHCS/CMS/Covered CA), and manage risk adjustment model analyses. The role includes team leadership, budgeting, and review of provider payment and capitation arrangements.

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and regulatory filings (DHCS, CMS, Covered CA)
Oversee risk score data analysis and risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Lead, coach, and develop an actuarial team with supervisory responsibilities
Support financial projections, budgeting, rate reviews, and provider payment agreements
Manager-level role based in Los Angeles, CA

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Supervisory or management experience leading actuarial staff
Knowledge of risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Deep understanding of capitation, shared risk settlements, and provider payments

KEY REQUIREMENTS

7+ years of actuarial experience in health insurance or managed care
4+ years of supervisory or management experience
ASA and MAAA or at least 4 Associate actuarial exams passed
Advanced Excel and proficiency with SQL, SAS, R, or Python

TECH STACK

Excel
Power_BI
PowerPoint

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Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and regulatory filings (DHCS, CMS, Covered CA)
Oversee risk score data analysis and risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Lead, coach, and develop an actuarial team with supervisory responsibilities
Support financial projections, budgeting, rate reviews, and provider payment agreements
Manager-level role based in Los Angeles, CA

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Supervisory or management experience leading actuarial staff
Knowledge of risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Deep understanding of capitation, shared risk settlements, and provider payments

KEY REQUIREMENTS

7+ years of actuarial experience in health insurance or managed care
4+ years of supervisory or management experience
ASA and MAAA or at least 4 Associate actuarial exams passed
Advanced Excel and proficiency with SQL, SAS, R, or Python

TECH STACK

Excel
Power_BI
PowerPoint

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Manage monthly financial reporting and regulatory filings (DHCS, CMS, Covered CA)
Oversee risk score data analysis and risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Lead, coach, and develop an actuarial team with supervisory responsibilities
Support financial projections, budgeting, rate reviews, and provider payment agreements
Manager-level role based in Los Angeles, CA

DOMAIN EXPERTISE

Actuarial experience in health insurance or managed care
Supervisory or management experience leading actuarial staff
Knowledge of risk adjustment models (CMS-HCC, RxHCC, CDPS+Rx)
Deep understanding of capitation, shared risk settlements, and provider payments