NEOGOV · 11 hours ago
Director, Actuarial Services (Director IV)
Orange, CA
Full-time
Onsite
Director/Executive
$204K/yr - $327K/yr
7+ years expCalOptima is a mission-driven community-based organization dedicated to serving member health with excellence and dignity. The Director of Actuarial Services will oversee all actuarial functions across the organization, providing leadership, mentoring staff, and collaborating to achieve organizational goals while advancing CalOptima Health's mission through data-driven insights and operational efficiency.
GovTechHuman ResourcesInformation TechnologySoftware
Responsibilities
Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department
Directs all aspects of actuarial functions and is accountable for the performance of the team
Maintains policies, procedures and standards for all department activities
Supports the Executive Director in departmental budget forecasts as needed
Implements efficiency improvements such as streamlining processes
Leads in the design, development, implementation and maintenance of report suites and dashboards for all levels of CalOptima Health management
Hires, manages, trains, supports, develops and evaluates direct reports
Performs ongoing staff and workflow analysis; establishes plans to ensure the team is adequately staffed
Provides strategic direction and guidance to staff, ensuring responsibilities are carried out in alignment with established departmental and organizational policies
Ensures improvement of knowledge and skill level is continuous for all department staff
Serves as subject matter expert in producing and maintaining incurred but not reported (IBNR) reserve estimates for all lines of business to provide the Accounting department with needed information for the month-end close
Directs the development of appropriate reimbursement rates and other financial contract provisions between CalOptima Health and the state of California; activities include completion of the annual Medi-Cal rate development template (RDT) and all supplemental data/rate requests as required by the state
Serves as lead authority on provider capitation rate development and pricing adjustments as appropriate
Directs and supports the team with the semi-annual Chronic Illness and Disability Payment System (CDPS) risk adjustment process
Develops actuarial studies and related financial operational processes and analytic tools to leverage system automation and enhance accuracy for actuarial analysis
Informs the Executive Director of significant changes or unusual trends in revenue, utilization and costs and proposes recommendations for consideration
Completes other projects and duties as assigned
Qualification
Required
Bachelor's degree in finance, math, business, statistics, economics, actuarial services or other related field PLUS 7 years of actuarial or analytics experience within health care 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
3 years of experience in a finance leadership role responsible for actuarial and/or analytics at a health plan, including direct supervision of staff, required
Preferred
Advanced degree in a related field
Tableau or Power BI experience
Experience leveraging artificial intelligence or machine learning for predictive analytics model development
Fellow of the Society of Actuaries (FSA)
Associate of the Society of Actuaries (ASA)
Benefits
CalPERS pension program and additional retirement packages.
A generous PTO program
A quality work life balance
Various wellness programs
Tuition Reimbursement
Professional development opportunities
Career development opportunities
Flexible scheduling
Company
NEOGOV
NEOGOV is the leading provider of workforce management software uniquely designed for the public sector, education, and public safety.
501-1000 employees
H1B Sponsorship
NEOGOV has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (10)
2023 (10)
2022 (18)
2021 (14)
2020 (16)
Funding
Current Stage
Late StageTotal Funding
$700MKey Investors
Warburg Pincus
2025-07-28Secondary Market· $700M
2025-07-28Acquired
2021-06-02Private Equity
Leadership Team
Shane Evangelist
CEO
Brandon McDonald
Head Of Marketing
Recent News
Canada NewsWire
2025-11-14
2025-11-14
Government Technology US
2025-10-31
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