Manager, Actuarial Services
Medicare AdvantageCommercial Employer HealthHealth OtherRegulatory ReportingUW Support & Portfolio ManagementPredictive Modelling & ML
Role Summary
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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
