Actuarial Analyst

The Team You'll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

Join Us in this Amazing Opportunity

We are hoping you will join us as an Actuarial Analyst and help shape the future of healthcare where you'll be an integral part of our Financial Analysis team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders.

This position has been approved to be Partial Telework
.

• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

The Actuarial Analyst will provide analytical and actuarial support to more senior team members for the month‑end Incurred But Not Reported (IBNR) reserve, semi‑annual Chronic Illness and Disability Payment System (CDPS) risk score and annual rate development template. You will also support the Manager Actuary and other departments throughout Cal Optima Health and may participate in ad‑hoc projects. Together, we are building a stronger, more equitable health system.

• 95% - Program Support
  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Assists in preparing, analyzing and reporting the monthly IBNR reserve estimate.
  • Assists in preparing and analyzing the semi-annual CDPS risk score and reporting the financial impact for the risk score adjusted capitation rate.
  • Reconciles the monthly paid claim between Facets reports and the data warehouse.
  • Reconciles and analyzes the weekly pharmacy invoices with the data warehouse.
  • Assists in preparing standard reports related to claims data and/or reserve estimation for internal and external auditors.
• 5% - Other
  • Completes other projects and duties as assigned.

• Bachelor's degree in actuarial science, mathematics, finance, economics, business administration or related field PLUS 1 year of experience with spreadsheets and databases required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

• Master's degree in actuarial science, mathematics, finance, economics, business administration or related field.
• Minimum of 1 actuarial exam with a passing score.
• Actuarial experience or equivalent.
• Experience with managed health care programs and financial modeling.

• N/A

• Develop rapport and establish and maintain effective working relationships with Cal Optima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position…