Senior Actuarial Analyst
Location: Orange, California US
Job Number: 5137
Position Title: Sr. Actuarial Analyst
The Senior Actuarial Analyst position will report to the Vice President of Actuarial Services and provide support in several different areas including reserves, risk adjustment, Part D and bid review. This would be a great opportunity for someone looking to deepen their actuarial knowledge while also expanding their operational knowledge.
General Duties/Responsibilities (May include but are not limited to):
· Understand and perform traditional actuarial methods to determine monthly reserve balances, RAF accruals and Part D pass through accruals
· Conduct audits of these approaches and recommend changes due to changing circumstance and operational deviations
· Work closely with HealthPlan Economics team and Medicare Risk Adjustment teams to review financial performance of markets and identify key opportunities and risks
· Monitor KPIs related to claim adjudication and utilization management
· Can explain purpose and function of actuarial methods and analyses to areas outside of the department
· Conduct and develop data driven analysis to support strategic decision making
· Assess risk and opportunities of these analyses
· Other duties as assigned
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Minimum Experience:
a. 3 years minimum of required work experience here
a. Requires college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
a. Previous knowledge of Medicare Advantage is preferred
b. ASA designation or has completed the majority of the courses to complete the ASA designation
c. Programming experience in SQL, R or Python is a plus
d. Curious mindset and eagerness to learn within the actuarial field and also outside the traditional actuarial field
4. Work Environment:
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].
Location City: Orange
Location State: California
Community / Marketing Title: Senior Actuarial Analyst
By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.
EEO Employer Verbiage:
Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].