JOB DESCRIPTION
Job Summary
Manages a process that blends standard actuarial modeling, medical economics, and financial reporting and analytics. Analyzes data for cost savings opportunities and performance improvement initiatives. Evaluates healthcare utilization and claims experience to identify areas of growth in coordination with health plan operational management. Collaborates with the Kentucky Finance, and corporate actuarial teams on IBNR calculations, capitation rate review, rate advocacy, and forecasting.
Job Duties
- Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies.
- Analyze results to identify early signs of trends or other issues related to medical care cost.
- Design and perform actuarial studies related to medical care costs and trends.
- Research and develop reports and analysis for senior management, effectively presenting and communicating results.
- Works closely with operational management to identify saving opportunities and areas of medical utilization concerns.
- Provide support to financial closing process regarding estimated settlements and risk corridor calculations.
- Pricing and tracking of capitation arrangements.
- Stay abreast of professional developments and industry trends.
- Provide guidance and mentorship to staff member.
JOB QUALIFICATIONS
REQUIRED EDUCATION:
Bachelor's Degree
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Minimum 6 years of experience in addition to leadership experience
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:
Must have passed at least 4 actuarial exams.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
ASA or near ASA
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Working at
Molina Healthcare
Molina Healthcare is a leading managed healthcare company dedicated to providing quality healthcare services to underserved communities. With a strong commitment to improving access to care, Molina Healthcare offers a wide range of health insurance plans and solutions. As an actuary at Molina Healthcare, you'll play a crucial role in assessing and managing risks to ensure the financial stability of the company's healthcare offerings. Actuaries at Molina Healthcare utilize their expertise in statistical analysis and risk assessment to develop pricing strategies, analyze healthcare trends, and provide insights that support evidence-based decision-making. Molina Healthcare's focus on serving vulnerable populations and providing cost-effective care creates unique challenges and opportunities for actuaries. Collaborating with cross-functional teams, actuaries at Molina Healthcare analyze complex healthcare data, identify trends, and develop innovative solutions that improve health outcomes while managing costs. Professional growth is highly valued at Molina Healthcare, and actuaries have access to ongoing training and development opportunities. Actuaries can enhance their skills and expertise while contributing to the company's mission of providing quality healthcare to those who need it most. Join Molina Healthcare's esteemed actuarial team and embark on a fulfilling career where you can make a meaningful impact on underserved communities, drive healthcare innovation, and enjoy a supportive work environment.