Actuary (Woodland Hills) Job in Woodland Hills 91302, California US
Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. The company provides health benefits to approximately 6.0 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as "Part D"), Medicaid, Department of Defense, including TRICARE, and Veterans Affairs programs. Health Net's behavioral health services subsidiary, Managed Health Network, Inc., provides behavioral health, substance abuse and employee assistance programs to approximately 5.4 million individuals, including Health Net's own health plan members. The company's subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
For more information on Health Net, Inc., please visit the company's website at www.healthnet.com .
JOB SUMMARY:
Provides actuarial management information necessary to keep the corporation financially sound. Provides Provider Network Management and our key partners information necessary to keep our strategic partnership programs financially sound. Identifies and analyzes internal and external factors which affect statistics for use in forecasting, trending, rate models, and quality and cost savings initiatives and designs specific actuarial studies and research projects as requested. May also assume a lead role in contract analysis, projections, and strategic planning support.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
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Works across highly matrixed organization and collaborates with others to retrieve, compile and verify data, prepare reports, and identify trends or patterns. Provides various levels of analysis and modeling work.
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Provides guidance and advice on clinical intiatives.
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Monitors level of trend and profitability for internal and external clients as needed
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Trains and may supervise other actuarial associates -- assigns work, checks work, organizes work and scheduling, and provides input for written performance appraisals.
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Performs actuarial research, experience studies, statistical analyses.
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May develop, calculate and analyze provider contract terms
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Develops and maintains documentation. Provides data to external agencies (auditors, DOI, DMHC) as needed.
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Attends and may lead company task forces or committees
- Compiles and verifies data, prepares reports.
- Provides various levels of analysis and modeling work.
- Develops actuarial assumptions.
- Participates in establishment of department goals and plans.
- Provides guidance and advice on rates, etc.
- Monitors level of trend and profitability.
- Oversees preparation of actuarial portions of financial statements.
- Monitors state/federal regulations to ensure compliance.
- Supervises analyses of sales, expense, and related factors for profitability reporting.
REQUIREMENTS:
Education:
4-year College Degree in Math, Stats, Econ, or Computer Science or equivalent experience. Passed five or more SOA exams.
Experience:
Four or more years applicable work experience in an HMO/health care environment.
OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.
Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.
