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Actuary - Medicare Advantage Oakland, CA

Posted By
2020-03-31 09:22:53
Job Type: Full Time only

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Job description
Provide actuarial services to develop best-practice actuarial models and promote implementation Program-wide. Maintain accountability for the development of the organization's rate structure, maintenance of adequate reserves, and development of new products. Provide data/analytic expertise to support actuarial services including financial reporting, trend analysis, utilization studies, rate development and claims liability estimates.

Essential Functions:

  • The Actuary is approaching high levels of technical actuarial specialization and expertise. Areas of specialization may include: Analysis and interpretation of product line financials to determine premium rates, profit forecasts, reserve adequacy, and other product line evaluations. Applies actuarial science and research, including monitoring developments in actuarial techniques, standards, and assumptions, and the legal and regulatory environment. Analysis and interpretation of product line financials, testing of reserve adequacy, valuation of liabilities, cash flow analysis, and product investment strategy. Determination of pricing structure and premiums, and the origination and evaluation of new product ideas, which are highly specialized, complex, and strategic.
  • Additionally: This position may advise management on actuarial or mathematical techniques in determining appropriate courses of action. This position may oversee projects as the highest level individual contributor.


Basic Qualifications:


• Minimum eight (8) years of actuarial experience and (ASA or FSA) or Fellowship (FSA from Society of Actuaries) & four (4) years of actuarial experience.


  • Bachelor's degree in mathematics, statistics, computer science, etc.
  • License, Certification, Registration
  • Attainment of ASA.

Additional Requirements:

  • •Analytical programming experience (use of Excel, Access, and other Business Intelligence tools).
  • Knowledge of core actuarial concepts (reserving, pricing, forecasting and trend analysis).
  • Understanding of health care cost structures (fee schedules, actuarial cost categories, and health care utilization codes).
  • Knowledge of key market segments (individual, small group, etc.) OR knowledge of key government programs (Medicare, Medicaid, etc.).
  • Must be able to work in a Labor/Management Partnership environment.

Key Skills: