Actuarial Analyst, Sr. Principal

Your Role   The Sr. Principal Actuarial Analyst for our Medi-Cal  team is responsible for overseeing rate development & rate analysis, Medi-Cal program analysis, experience reporting, and Medi-Cal program strategy. This position requires directly managing 1 actuarial analyst and partnering with Senior Leadership and cross-functional teams to drive successful strategy and analytics. This role will report directly to the Senior Director of Medicare Finance & CFO Promise Health Plan. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your Work In this role, you will:Rate Development/Analysis; Influence & Negotiation Be responsible for developing, updating, and evaluating all rate packages from DHCS including development factors, trend support, actuarial assumptions, program analysis, and risks or opportunitiesReport to the CFO of Promise Health Plan and senior executives of Promise Health Plan financial opportunities and areas of focus for performance optimizationAssist with, and influence, rate negotiation and rate guidanceRevenue & Cost of Healthcare Forecasting for Medi-Cal / Promise Health PlanDevelop, implement, manage and own advanced analytics projects from end to end and proactively add improvements and enhancementsExplain and influence the project to audiences outside the job function and to senior leaders.  Will drive and ensure alignment of project with team goals and long-term strategic goalsConduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluate actuarial risk related analysisMedi-Cal Program Actuarial Support & Revenue optimization Financial and Actuarial Process support and Talent development Medi-Cal strategy development & program planningActs as the lead subject matter expert in the data areas of claim, premium, membership, and/or risk score assignmentWork closely with Senior Leadership at Promise Health Plan to understand strategic direction and financial strengths and opportunitiesPartner with financial and actuarial leaders to strengthen finance and actuarial processes and build strong talent pipelinesPartner with CFO of Promise Health Plan on annual budget setting process and on-going forecasting processesResponsible for evaluating and explaining monthly financial variances to plan for revenue and cost of healthcareUnderstand the core principles and act as an expert within a specialized discipline, along with the functionality underlying decision, descriptive, predictive and prescriptive advanced analytic methods Your Knowledge and Experience Requires a college degree in mathematics, statistics, computer science or equivalent business experience Requires 10 years of professional health actuarial experience. Requires a minimum of 5 years of experience in health actuarial pricing Requires an ASARequires expertise in the California Medi-Cal program, from either the carrier or consultant side Requires experience in rate development, rate analysis, and performance evaluation of a health plan Requires extensive knowledge of job area (including health plan operations) and regulations obtained through professional experience and advanced educationRequires a mastery level knowledge within the Actuarial job area and may have deeper knowledge of project managementRequires a high proficiency in applied statistics skills, such as distributions, statistical testing, and regression  Requires the ability to program in SQL, SAS and/or Tableau, and experience with common data science toolkits such as R and Python  

Created: 2025-02-22