L.A. Care Health Plan · 2 hours ago
Manager, Actuarial Services
Los Angeles, CA
Full-time
Onsite
Senior Level
$135K/yr - $216K/yr
7+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, providing health coverage to low-income residents in Los Angeles County. The Manager, Actuarial Services is responsible for overseeing staff and managing financial reporting, actuarial analyses, and compliance with regulatory standards.
FitnessGovernmentHealth Care
Responsibilities
Manage the Monthly Financial Reporting and Analysis
Review reports to ensure consistency and appropriateness of methodologies used
Ensure actuarial assumptions, methodologies, and documentation meet regulatory standards
Interpret results and recommend solutions to identified issues
Provide assistance in ad-hoc projects related to rate filings, new business development, financial projections, budgeting, and acquisitions
Provide assistance in company financial projections
Oversee the production, validation, and documentation of actuarial reports along with shared risk settlement estimates and regular analyses of revenue and cost trends across benefits and programs
Manage risk score data analysis and reporting for all lines of business
Review rates and other at-risk payments from DHCS, CMS, Covered CA, or other governmental agencies
Review financial agreements involving health care risk
Manage staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others
Manage complex projects, engaging and updating key stakeholders, developing timelines, lead others to complete deliverables on time and ensure implementation upon approval
Responsible for reporting, budgeting, and policy implementation
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Mathematics or Related Field
At least 7 years of actuarial experience in health insurance or managed care environment
At least 4 years of leading staff or supervisor/management experience
Experience leading teams, projects, initiatives, or cross-functional groups
Thorough understanding of health care cost structures (fee schedules, health care cost categories, and health care utilization codes)
Knowledge of health care industry, including health plans, and providers
Deep understanding of delegated risk arrangements, including capitation shared risk settlements, risk corridors, and provider settlements
Ability to recruit, develop, and motivate actuarial staff
Expertise in evaluating complex data and financial impacts
Ability to align actuarial analyses with organizational goals and regulatory requirements
Familiarity with probability theory, calculations and applicability to managing financial risk
Proficient with SQL, SAS, R, Python, or Power BI; advanced Excel modeling required
Strong verbal, written communication and executive-level presentation skills
Knowledge of the industry's trends, market dynamics, directions, major issues, regulatory considerations and trendsetters
Knowledge of finance, accounting and actuarial concepts and practices as applied to the industry
Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment
Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision
Skilled in mediating disputes and resolving conflicts in a fair and constructive manner
Must have a deep understanding of financial principles
Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation
Ability to make informed decisions
Deep understanding of organizational operations to identify opportunities and navigate challenges
Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals
Attainment of Associateship in the Society of Actuaries (ASA) and Membership in the American Academy of Actuaries (MAAA) or at least 4 Associate exams passed
Preferred
Master's Degree in Mathematics or Related Field
Experience with risk adjustment models (CDPS+Rx, CMS-HCC, RxHCC, etc.) and provider payment methodologies
Experience with at least one major line of business: Medical, Medicare Advantage / Dual Eligible Special Needs Plan (D-SNP), or Commercial
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
2026-01-17
MarketScreener
2025-08-27
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