Mgr, Actuarial Svcs (KY Health Plan) - REMOTE - Military Veterans
at Molina Healthcare
JOB DESCRIPTION
Job Summary
Manages a process that blends standard actuarial modeling, medical economics, and financial reporting and analytics. Analyzes data for cost savings opportunities and performance improvement initiatives. Evaluates healthcare utilization and claims experience to identify areas of growth in coordination with health plan operational management. Collaborates with the Kentucky Finance, and corporate actuarial teams on IBNR calculations, capitation rate review, rate advocacy, and forecasting.
Job Duties
- Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies.
- Analyze results to identify early signs of trends or other issues related to medical care cost.
- Design and perform actuarial studies related to medical care costs and trends.
- Research and develop reports and analysis for senior management, effectively presenting and communicating results.
- Works closely with operational management to identify saving opportunities and areas of medical utilization concerns.
- Provide support to financial closing process regarding estimated settlements and risk corridor calculations.
- Pricing and tracking of capitation arrangements.
- Stay abreast of professional developments and industry trends.
- Provide guidance and mentorship to staff member.
JOB QUALIFICATIONS
REQUIREDEDUCATION:
Bachelors Degree
REQUIREDEXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Minimum 6 years of experience in addition to leadership experience
REQUIREDLICENSE,CERTIFICATION,ASSOCIATION:
Must have passed at least 4 actuarial exams.
PREFERREDLICENSE,CERTIFICATION,ASSOCIATION:
ASA or near ASA
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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Pay Range: $79,607.91 - $172,483.8 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
United States / Remote
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.