JOB DESCRIPTION
Job Summary
Leads and manages team responsible for subject matter expertise in Medicaid risk adjustment in multiple states. Activities include extracting, analyzing, and synthesizing data from various sources to identify risks and opportunities; also supports analysis and reporting to operational and finance partners.
Essential Job Duties
• Reviews reporting prepared by actuarial team to assure consistency and appropriateness of methodologies used.
• Collaborates with operational and finance teams to identify risks and develop solutions.
• Oversees the maintenance of risk adjustment models and evaluation of results.
• Designs and performs actuarial studies related to risk adjustment calculations and accuracy.
• Supports ad-hoc projects related to rate adequacy, financial projections, and intervention program strategy.
• Hires, onboards, trains, mentors, manages and provides technical guidance and leadership to actuarial staff.
• Stays abreast of actuarial professional developments and industry trends.
Required Qualifications
• At least 7 years of actuarial experience, or equivalent combination of relevant education and experience.
• At least 1 year of management/leadership experience.
• Associate in Society of Actuaries (ASA) and Member of American Academy of Actuaries (MAAA).
• Bachelor’s degree in actuarial, mathematics, statistics, economics or related field.
• Demonstrated subject matter expertise in at least one actuarial function (pricing, reserving, risk adjustment, analytics, modeling, etc.)
• Ability to justify actuarial judgements with well- supported and/or well-reasoned arguments.
• Ability to provide insights to leadership based on actuarial review.
• Advanced understanding of statistics/predictive analytics.
• Demonstrated problem-solving skills.
• Strong critical-thinking and attention to detail.
• Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Proficient in Microsoft Office suite products, including key skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Skills Required
- At least 7 years of actuarial experience, or equivalent combination of relevant education and experience.
- At least 1 year of management/leadership experience.
- Associate in Society of Actuaries (ASA) and Member of American Academy of Actuaries (MAAA).
- Bachelor's degree in actuarial, mathematics, statistics, economics or related field.
- Demonstrated subject matter expertise in at least one actuarial function (pricing, reserving, risk adjustment, analytics, modeling, etc.).
- Ability to justify actuarial judgements with well-supported and/or well-reasoned arguments.
- Ability to provide insights to leadership based on actuarial review.
- Advanced understanding of statistics/predictive analytics.
- Demonstrated problem-solving skills.
- Strong critical-thinking and attention to detail.
- Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
- Strong verbal and written communication skills.
- Proficient in Microsoft Office suite products, including key skills in Excel (VLOOKUPs and pivot tables), and applicable software program(s) proficiency.
What We Do
Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.
