Inland Empire Health Plans
Director, Actuarial Services - Products
Inland Empire Health Plans, Rancho Cucamonga, California, United States, 91739
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 Medicare and Commercial (i.e., Covered CA) line of business. This includes, but is 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. This position collaborates with other IEHP business units in planning and developing strategies to maximize the financial performance. This leader will oversee credentialed actuaries and actuarial team members to support the department functions, in addition to collaboration with inter-departments to ensure member needs are met while simultaneously building strong peer relationships.Major Functions (Duties and Responsibilities)
Lead development of pricing, experience analysis, and financial forecast modeling for all lines of business.Develop product analytics to define and measure financial performance.Lead actuarial function on Medi-Cal Rate Development Template (RDT) support and other state data requests.Perform Medi-Cal revenue rate analysis and serve as Subject Matter Expert (SME) for Medi-Cal rate advocacy.Oversee development for Medicare bids, regulatory rate filings and other required regulatory submissions for the assigned lines of business.Collaborate with IEHP business units in planning and developing strategies to maximize the financial performance.Communicate clearly and present appropriate level of information to senior leaders.Research, evaluate and analyze the market landscape for the assigned lines of business.Lead a team of analysts to ensure cohesive team culture and effective collaboration with other business units.Manage the respective actuarial service unit including recruiting, training, and coaching Team Members.Commitment to Quality:
The IEHP Team is committed to incorporating 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; we also aim to match our Team Members with the same energy by providing prime benefits and more.CalPERS retirement457(b) option with a contribution matchGenerous paid time off- vacation, holidays, sickState of the art fitness center on-siteMedical Insurance with Dental and VisionPaid life insurance for employees with additional optionsShort-term, and long-term disability optionsPet care insuranceFlexible Spending Account – Health Care/ChildcareWellness programs that promote a healthy work-life balanceCareer advancement opportunities and professional developmentCompetitive salary with annual merit increaseTeam bonus opportunitiesEducation & Experience
Minimum ten (10) years of actuarial experience in the Health Care industryProven strategy actuarial or analytic leadership experience in working with cross-functional teamsData analysis experience in a healthcare settingFive (5) years of managing experience is requiredBachelor’s degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is requiredKey Qualifications
Principles and practices of managed health care industry and strategiesStrong understanding of healthcare market landscapeKnowledge of accounting/finance conceptsExtensive knowledge of MS Excel, PowerPointStart your journey towards a thriving future with IEHP and apply
TODAY !
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authentic experience!This Director is responsible for pricing, performance management, and forecasting for IEHP’s Medicare and Commercial (i.e., Covered CA) line of business. This includes, but is 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. This position collaborates with other IEHP business units in planning and developing strategies to maximize the financial performance. This leader will oversee credentialed actuaries and actuarial team members to support the department functions, in addition to collaboration with inter-departments to ensure member needs are met while simultaneously building strong peer relationships.Major Functions (Duties and Responsibilities)
Lead development of pricing, experience analysis, and financial forecast modeling for all lines of business.Develop product analytics to define and measure financial performance.Lead actuarial function on Medi-Cal Rate Development Template (RDT) support and other state data requests.Perform Medi-Cal revenue rate analysis and serve as Subject Matter Expert (SME) for Medi-Cal rate advocacy.Oversee development for Medicare bids, regulatory rate filings and other required regulatory submissions for the assigned lines of business.Collaborate with IEHP business units in planning and developing strategies to maximize the financial performance.Communicate clearly and present appropriate level of information to senior leaders.Research, evaluate and analyze the market landscape for the assigned lines of business.Lead a team of analysts to ensure cohesive team culture and effective collaboration with other business units.Manage the respective actuarial service unit including recruiting, training, and coaching Team Members.Commitment to Quality:
The IEHP Team is committed to incorporating 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; we also aim to match our Team Members with the same energy by providing prime benefits and more.CalPERS retirement457(b) option with a contribution matchGenerous paid time off- vacation, holidays, sickState of the art fitness center on-siteMedical Insurance with Dental and VisionPaid life insurance for employees with additional optionsShort-term, and long-term disability optionsPet care insuranceFlexible Spending Account – Health Care/ChildcareWellness programs that promote a healthy work-life balanceCareer advancement opportunities and professional developmentCompetitive salary with annual merit increaseTeam bonus opportunitiesEducation & Experience
Minimum ten (10) years of actuarial experience in the Health Care industryProven strategy actuarial or analytic leadership experience in working with cross-functional teamsData analysis experience in a healthcare settingFive (5) years of managing experience is requiredBachelor’s degree in Actuarial Sciences, Statistics, Finance, Mathematics, or related field from an accredited institution is requiredKey Qualifications
Principles and practices of managed health care industry and strategiesStrong understanding of healthcare market landscapeKnowledge of accounting/finance conceptsExtensive knowledge of MS Excel, PowerPointStart your journey towards a thriving future with IEHP and apply
TODAY !
#J-18808-Ljbffr