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Sr Mgr, Actuarial Services - Medicare experience needed

Kaiser Permanente

Oakland, CAJobSeen 2w agoSeen in employer's feed 2 days ago

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At a glance

Compensation
No compensation found
Location
Oakland, CA
Work Authorization
Not specified

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Requirements

Credentials this posting asks for.

Associate Of The Society Of Actuaries Certificate Or Associate Of The Casualty Actuarial Society CertificateBachelor's degree

Job overview

The Senior Manager provides actuarial leadership for Medicare pricing and financial strategy, overseeing EGWP Medicare Advantage and Part D products across multiple markets while managing pricing methodologies, forecasting, risk assessment, and regulatory implications.

Skills & qualifications

RequiredNice to have

Skills

Ambiguity/Uncertainty ManagementAttention to DetailBusiness KnowledgeCommunicationConstructive FeedbackCritical ThinkingCross-Group CollaborationDecision MakingDependabilityDiversity, Equity, and Inclusion SupportDrives ResultsFacilitation SkillsHealth Care IndustryInfluencing OthersIntegrityLeadershipLearning AgilityOrganizational SavvyProblem SolvingShort- and Long-Term Learning & RecallStrategic ThinkingTeam BuildingTeamworkTopic-Specific CommunicationAnalytical SkillsClient FocusDebugging and TroubleshootingDemonstrating Personal FlexibilityEconomicsGetting Work Done Through OthersInitiativeMaintain Files and RecordsManaging Diverse RelationshipsMathematicsNegotiationOrganizational SkillsProject ManagementStatistical Programming LanguageStress ToleranceTechnical Communication

Qualifications

Two Years Supervisory ExperienceBachelor's in Mathematics or Related FieldAssociate of the Society of Actuaries Certificate or Associate of the Casualty Actuarial Society CertificateSix Years Experience With Databases and SpreadsheetsBachelor's in Statistics, Actuarial Science, Mathematics, Engineering, or Physics

Full job description

This Senior Manager provides actuarial leadership for Medicare pricing and financial strategy, with primary responsibility for Employer Group Waiver Plan (EGWP) Medicare Advantage and Part D products across multiple geographic markets. The position is accountable for managing EGWP pricing methodologies, financial forecasting, and risk assessment activities that support product strategy, business planning, and long-term financial performance.

In addition, the Senior Manager will serve as a subject matter expert and lead the assessment of the actuarial and financial implications associated with Medicare policy developments, including CMS Advance/Final Notices, Proposed and Final Rules, and other regulatory and legislative actions affecting Medicare programs (both Individual and Group).

Job Summary:

This managing level employee is primarily responsible for developing and providing recommendations on avoiding financial risk to the organization, leading the completion of actuarial documentation, developing and designing product line evaluations and new or advanced actuarial models, and assessing, analyzing, and interpreting financial risk and opportunity for presentation to mid-level stakeholders.

Essential Responsibilities:

  • Pursues professional growth and provides developmental opportunities for others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; hiring, training, and developing talent for growth opportunities; delegating tasks and decisions; fostering open dialogue amongst departments; strategically evaluating talent for succession planning; setting performance management guidelines and expectations across units; and working closely with employees to set goals and provide open feedback and coaching to drive performance improvement.

  • Manages designated units by translating business plans into tactical action items; communicating goals and objectives; ensuring all policies and procedures are followed; overseeing the completion of work assignments; assuming responsibility for decision making; aligning team efforts; building accountability for and measuring progress in achieving results; incorporating resources, costs, and forecasts into unit plans; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; partnering with key stakeholders and business leaders to ensure products and/or services meet requirements and expectations while aligning with departmental strategies; and influencing units to operate in alignment with business objectives.

  • Completes actuarial documentation by reviewing and coordinating the actuarial portion of financial reports and tax returns, and responses to insurance regulations; recommending report needs; and presenting results internally to mid-level leadership.

  • Develops and designs product line evaluations by interpreting and communicating findings of analysis of product line financials, pricing, reserve, valuation , cash flow analysis; interpreting product line performance, risk, and assumptions used in product development; and coaches and develops staff while ensuring business needs or requirements are met.

  • Designs and develops actuarial research by designing complex methods to advance standards, assumptions, and the legal and regulatory environment; and ensuring staff completes activities.

  • Assesses, analyzes and interprets financial risks and opportunities by using non-traditional actuarial methods and actuarial judgment when conducting actuarial analyses; and coaches and develops staff while ensuring business needs or requirements are met.

  • Leads collaboration with business partners by translating complex actuarial constructs into actionable recommendations; and developing and formulating accurate actuarial and financial advice in compliance with the Actuarial Standards of Practice; and coaches and develops staff while ensuring business needs or requirements are met.

  • Creates framework and assumptions for new, existing, and non-traditional actuarial models to meet business needs; and coaches and develops staff while ensuring business needs or requirements are met.

Knowledge, Skills and Abilities: (Core)

  • Ambiguity/Uncertainty Management

  • Attention to Detail

  • Business Knowledge

  • Communication

  • Constructive Feedback

  • Critical Thinking

  • Cross-Group Collaboration

  • Decision Making

  • Dependability

  • Diversity, Equity, and Inclusion Support

  • Drives Results

  • Facilitation Skills

  • Health Care Industry

  • Influencing Others

  • Integrity

  • Leadership

  • Learning Agility

  • Organizational Savvy

  • Problem Solving

  • Short- and Long-term Learning & Recall

  • Strategic Thinking

  • Team Building

  • Teamwork

  • Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

  • Analytical Skills

  • Client Focus

  • Debugging and Troubleshooting

  • Demonstrating Personal Flexibility

  • Economics

  • Getting Work Done Through Others

  • Initiative

  • Maintain Files and Records

  • Managing Diverse Relationships

  • Mathematics

  • Negotiation

  • Organizational Skills

  • Project Management

  • Statistical Programming Language

  • Stress Tolerance

  • Technical Communication

  • Trust

Minimum Qualifications:

  • Minimum two (2) years supervisory experience

  • Bachelors degree in mathematics or related field AND Minimum eight (8) years actuarial experience. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.

  • Associate of the Society of Actuaries Certificate OR Associate of the Casualty Actuarial Society Certificate

Preferred Qualifications:

  • Six (6) years experience with databases and spreadsheets.

  • Bachelor's degree in statistics, actuarial science, mathematics , engineering, or physics.

COMPANY: KAISER

TITLE: Sr Mgr, Actuarial Services - Medicare experience needed

LOCATION: Oakland, California

REQNUMBER: 1445764

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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