Director, Actuarial Services - Products

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

This Director is responsible for pricing, performance management, and forecasting for IEHP’s Medi-Cal, Medicare and Commercial (i.e., Covered CA) lines of business, which includes, but not limited to, the development of product analytics to define and measure the financial performance and providing actuarial support to other business units for the two lines of business. The Director, Actuarial Services - Products collaborates with other IEHP business units in planning and developing strategies to maximize the financial performance and will oversee credential actuaries and actuarial team members to support the department functions.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• CalPERS retirement.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Lead development of pricing, experience analysis, and financial forecast modeling for all lines of business.
2. Develop product analytics to define and measure financial performance.
3. Lead actuarial function on Medi-Cal Rate Development Template (RDT) support and other state date requests.
4. Perform Medi-Cal revenue rate analysis and serve as Subject Matter Expert (SME) for Medi-Cal rate advocacy.
5. Oversees development for Medicare bids, regulatory rate filings and other required regulatory submissions for the assigned lines of business.
6. Collaborate with IEHP business units in planning and developing strategies to maximize the financial performance.
7. Communicate clearly and present appropriate level of information to senior leaders.
8. Research, evaluate and analyze the market landscape for the assigned lines of business.
9. Lead a team of analysts to ensure cohesive team culture and effective collaboration with other business units.
10. Manage the respective actuarial service unit including recruiting, training, and coaching Team Members.

Education & Requirements 

• Minimum ten (10) years of actuarial experience in Health Care industry
• Proven strategy actuarial or analytic leadership experience in working with cross-functional teams
• Data analysis experience in a healthcare setting
• A minimum of five (5) years of managing experience is required
• Medicare and/or ACA experience is preferred
• Bachelor’s degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is required
• Associate of the Society of Actuaries (ASA) is required
• Fellow of the Society of Actuaries (FSA) is preferred

Key Qualifications

• Principles and practices of managed health care industry and strategies
• Strong understanding of healthcare market landscape
• Knowledge of accounting/finance concepts
• Extensive knowledge of MS Excel, Power Point
• Knowledge of SQL Programming or relational database is preferred
• Strong conceptual problem-solving skills
• Strong quantitative and financial analysis skills. Excellent interpersonal and communication skills (both oral & written)
• Proven ability to:

• Show sharp attention to detail
• Possess a strong work ethic
  • Be an expansive learner
• Work independently and manage a team and take initiative
• Identify and resolve problems, think creatively, strategically, and analytically
• Apply extensive knowledge of actuarial methods and procedures
• Handle multiple competing priorities
• Effectively communicate in variety of prestation setting and to influence key stakeholders to drive meaningful change and innovation
• Be comfortable with senior management audiences, and/or diverse group setting
• Possess a strong commitment to quality
• Consistently and thoroughly review work for accruing prior to deliverable

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)