CalOptima is a mission-driven community-based organization dedicated to serving member health with excellence and dignity. As an Actuarial Analyst, you will provide analytical and actuarial support to the Financial Analysis team, assisting in various projects and ensuring the accuracy of financial data related to healthcare services.
Responsibilities
- 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
- Completes other projects and duties as assigned
Skills
- 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
Benefits
- A comprehensive benefits package
- 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 Overview
CalOptima is a county organized health system that provides health insurance programs. It was founded in 1993, and is headquartered in Orange, California, USA, with a workforce of 1001-5000 employees. Its website is https://www.caloptima.org/.
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