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Manager, Actuarial Services (Remote) CA Residents Only 25-00502

Alura Workforce Solutions

Rancho Cucamonga, CA(remote)

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JOB DETAILS
SKILLS
Actuarial Skills, Analysis Skills, Behavioral Health, Cisco ASA (Adaptive Security Appliance), Communication Skills, Detail Oriented, Documentation, External Audit, Flexible Spending Accounts, Forecasting, Government, Health Plan, Healthcare, Identify Issues, Interpersonal Skills, Leadership, Medi-Cal, Medicaid, Nonprofit, Operations Planning, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Provider Contracting, Reimbursement, Risk, SQL (Structured Query Language), Statistics, Strategic Analysis, Team Lead/Manager, Team Player, Training/Teaching, Trend Analysis, Work From Home, Writing Skills
LOCATION
Rancho Cucamonga, CA
POSTED
30+ days ago
Job Title
Manager, Actuarial Services
Remote / California Residents Only

Our Client
Our client is a mission-driven, not-for-profit health plan serving more than 1.6 million residents across Southern California. They maintain a large provider network and focus on accessible, community-centered care with strong programs in prevention, care coordination, behavioral health, and overall member well-being.
The organization is regularly recognized as a top workplace, earning repeated “Best Place to Work” honors and consecutive Great Place to Work® certifications. Employees describe a collaborative, supportive culture with strong work–life balance, competitive benefits, and clear opportunities for growth and meaningful impact.

Position Overview
The Manager of Actuarial Services is responsible for managing a team of analysts that provides actuarial support to various departments and company key initiatives.  Provide actuarial analysis and proactive recommendations to management on both tactical and strategic nature.

Key Responsibilities
  • Perform actuarial research, experience studies and statistical analyses
  • Develop actionable recommendations to management relative to all analyses
  • Calculate monthly IBNR and reserves
  • Provide actuarial support for financial forecasts and monitor financial results
  • Perform actuarial analysis to assist with provider contracting effort
  • Assist with rate development and perform reviews for data adequacy and actuarial soundness
  • Evaluate Government reimbursement processes to determine areas of risk and opportunity
  • Oversee health plan experience, identify trends, and recommend improvements
  • Develop and maintain documentation and provide data to external agencies like auditors, DOI, DMHC, DHCS, etc.) as needed
  • Perform ad hoc actuarial projects and other duties as assigned or requested. Serve as a subject matter expert for these activities
  • Provide training and guidance to other actuarial associates
  • Perform any other duties as required to ensure Health Plan operations and department business needs are successful
Key Qualifications
  • SQL Programming knowledge is preferred
  • Excellent interpersonal and communication skills (both oral & written) and
    organization skills
  • Ability to work independently and take initiative
  • Ability to identify and resolve problems, think creatively, strategically, and analytically
  • Ability to apply extensive knowledge of actuarial methods and procedures
  • Extremely organized, sharp attention to detail, strong work ethic, expansive learner
  • Telecommuting: Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval
  • All positions approved for telecommute or hybrid work locations may periodically be required to report to main campus for mandatory in-person meetings or for other business needs as determined by leadership
 
Education & Requirements 
  • At least six (6) years of actuarial experience with the ASA and health care experience
  • Actuarial experience in the healthcare industry is required
  • Leadership experience required
  • Medicaid experience is preferred. Medi-Cal experience is highly desired
  • Bachelor’s degree from an accredited institution required
  • Associate of the Society of Actuaries (ASA) is required
  • Fellow of the Society of Actuaries (FSA) is preferred
Additional Information
  • Direct Placement
  • Remote/California Residents Only
INDH

About the Company

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Alura Workforce Solutions