Manager Actuarial Analytics (Medicare/Medicaid)

Role: Manager Actuarial Analytics (Medicare/Medicaid)
Location: Portland, OR
Type: FTE/Permanent

Job Description:

• Lead the review of Medicaid capitation rate assumptions and methodology
• Provide oversight to financial/encounter data submission in support of Medicaid capitation rate setting
• Provide expertise and consultation to support the Medicare bid process and pricing strategy
• Evaluate the financial performance for Medicaid/Medicare lines of business
• Maintain an understanding of the changing health care trends and actuarial regulations and how they impact the organization
• Remain current on government regulation and guidance as well as analytic techniques and methodologies, data sources
• Build and maintain relationships with other leaders across the organization including Product, Finance, Regulatory, Pharmacy, and outside the organization (CMS, provider groups)
• Coach and set priorities for direct reports

Required qualifications:

• Bachelor's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
• 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development
• Experience with writing queries in SQL or another programming language
• Demonstrated experience applying project management skills in data-related and financial analysis projects

Preferred qualifications:

• Master's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
• Fellow or Associate in the Society of Actuaries (FSA or ASA)
• Experience certifying the Medicare Advantage Bid
• Experience with Commercial, Medicare, and Medicaid revenue methodologies
• Demonstrated experience with managing professional staff who work independently on tasks and projects