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Lead Actuary Medicare Advantage

Clinical Management Consultants

This is a Contract position in Alameda, CA posted September 17, 2020.

This outstanding healthcare system in the San Francisco Bay Area is actively interviewing for a Lead Actuary to oversee the regional Medicare Advantage program. Join this highly rated healthcare organization and experienced administrative team in supporting world class patient care.

Supporting over a dozen hospitals in Northern California, this health system has earned praise for its proactive and progressive patient care models, as well as its commitment to underserved populations. Through in-depth analysis of over a hundred revenue/cost centers, the Lead Actuary will play an integral role in developing the insurance rates and rating systems for groups throughout the Health Plan’s Medicare Advantage network.

Reporting to the Regional Actuarial Project Manager, the Medicare Advantage Lead Actuary will serve as project lead, defining scope, coordinating activities, and ensuring efficient completion of actuarial studies. Working closely with a team of ASA Actuaries who further specialize, the Actuarial Specialist will provide guidance and support in developing a statistical knowledge base about the marketplace and business environment.

The Health Plan Medicare Lead Actuary will play a lead role in setting the pace of work for the department, and in performing the actual analysis that supports pricing strategy and policy for the entire region and network. Strong organization in complex data environments is necessary, as is the ability to provide direction and support to the Actuary Team.

This Actuary will serve as the Medicare Advantage liaison and specialist with Senior Managers on various product and project teams, conducting market research, developing complex sets of group rates and rating structures, and making actionable recommendations. One of the major project teams is Medicare Advantage and Medicare Part D. At least 2 years of experience with these products is required. This person will get to directly support decision making through the interpretation and communication of key findings in these research processes, and will help ensure the accuracy of all actuarial information used to define policy.

Those who are new to the San Francisco Bay Area and those who’ve lived there for years, each discover the same thing: it has something for everyone! No matter what direction you travel, great things await. A drive North will put the Medicare Advantage Lead Actuary in the middle of California Wine Country, with all the beautiful vistas and multi-colored orchards. An hour west and you’re in the heart of San Francisco, where haute cuisine, world-class theater, and all manner of nightlife await. South and East take you to long hikes, large open skies, as many outdoor activities as you could want. Nearly anywhere you settle, you’ll find some of America’s top schools, a community of compassionate neighbors, and fantastic weather.

Join this outstanding California Health Care System, and discover an area that bridges the gap between small town feel and big city flavor. The Lead Actuary will find the peace of mind that comes with a stable position in a trusted hospital system, a generous benefits package, and competitive compensation.

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