Actuarial Analyst V - Medicare Advantage experience

Kaiser Permanente; Oakland (CA); Hybrid; USD 170,000 - 220,000; Full time

Job summary

Kaiser Permanente in Oakland, CA, seeks an experienced actuarial professional to research and evaluate financial risk, align actuarial work with financial reporting, and design product-line evaluations. This role emphasizes actuarial modeling, CMS regulatory knowledge, and collaboration with cross-functional teams.

The position focuses on developing and maintaining actuarial documents, evaluating risk and opportunity, and translating complex analyses into practical business guidance for

Qualifications

• Bachelor's degree in mathematics or related field; 8+ years actuarial experience.
• Associate CAS or SOA certificate.

Responsibilities

• Leads cross-functional projects and mentors junior team members.
• Develops actuarial models and financial analyses for product lines.
• Prepares actuarial documentation for financial reports and tax returns.
• Translates actuarial findings into actionable business recommendations.
• Ensures compliance with CMS regulations in Medicare Advantage bid processes.

Skills

Attention to Detail

Communication

Problem Solving

Analytical Skills

Decision Making

Project Management

Teamwork

Health Care Industry

Cross-Group Collaboration

Learning Agility

Education

Bachelor's degree in mathematics or related field

CAS/SOA actuarial certificate

Tools

SQL

VBA

Excel

Databases

Job description

This role supports the build and maintenance of tools used to file Medicare Advantage bids. The role additionally supports tools that help drive bid strategy within Kaiser. Most day to day work occurs in excel but proficiency in SQL or VBA allows deeper study of the data supporting the tools and creating efficiencies. A strong background in the Medicare Advantage bid process and the CMS regulations supporting bid is required for this role.

Job Summary

This individual contributor is primarily responsible for researching and determining the likelihood of financial risk to the organization, aligning actuarial documentation with financial reports and tax returns, developing and designing product line evaluations and actuarial models, and assessing, analyzing, and interpreting financial risk and opportunity.

Essential Responsibilities

• Practices self-leadership and promotes learning in others by building relationships with cross-functional stakeholders; communicating information and providing advice to drive projects forward; influencing team members within assigned unit; listening and responding to, seeking, and addressing performance feedback; adapting to competing demands and new responsibilities; providing feedback to others, including upward feedback to leadership and mentoring junior team members; creating and executing plans to capitalize on strengths and develop weaknesses; and adapting to and learning from change, difficulties, and feedback.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promoting adherence to all procedures and policies; developing work plans to meet business priorities and deadlines; determining and carrying out processes and methodologies; coordinating and delegating resources to accomplish organizational goals; partnering internally and externally to make effective business decisions; solving complex problems; escalating issues or risks as appropriate; monitoring progress and results; recognizing and capitalizing on improvement opportunities; and evaluating recommendations made by others.
• Completes actuarial documentation by reviewing and coordinating the actuarial portion of financial reports and tax returns, and responses to insurance regulations; and presenting results internally to mid-level leadership.
• Develops and designs product line evaluations by interpreting and communicating findings of analysis of product line financials, reserve, valuation , cash flow analysis; and interpreting product line performance, risk, and assumptions used in product development.
• Designs and develops actuarial research by designing complex methods to advance standards, assumptions, and the legal and regulatory environment.
• Assesses, analyzes and interprets financial risks and opportunities by using non-traditional actuarial methods and actuarial judgment when conducting actuarial analyses.
• Leads collaboration with business partners by translating complex actuarial constructs into actionable recommendations; and developing and formulating accurate actuarial and financial advice in compliance with the Actuarial Standards of Practice.
• Creates framework and assumptions for new, existing, and non-traditional actuarial models to meet business needs.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Analytical Skills
• Client Focus
• Debugging and Troubleshooting
• Demonstrating Personal Flexibility
• Economics
• Getting Work Done Through Others
• Initiative
• Maintain Files and Records
• Managing Diverse Relationships
• Mathematics
• Negotiation
• Organizational Skills
• Project Management
• Statistical Programming Language
• Stress Tolerance
• Technical Communication
• Trust

Minimum Qualifications

• Bachelors degree in mathematics or related field AND Minimum eight (8) years actuarial experience. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.
• Associate of the Casualty Actuarial Society Certificate OR Associate of the Society of Actuaries Certificate

Preferred Qualifications

• Two (2) years experience in a leadership role with or without direct reports.
• Six (6) years experience with databases and spreadsheets.

Primary Location: California,Oakland,Ordway

Scheduled Weekly Hours: 40

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri

Working Hours Start: 08:00 AM

Working Hours End: 05:00 PM

Job Schedule: Full-time

Job Type: Standard

Worker Location: Flexible

Worker location must align with Kaiser Permanente's Authorized States policy.

Employee Status: Regular

Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee

Job Level: Individual Contributor

Department: Po/Ho Corp - HP PROD MGMT-Actuarial SVCS - 0308

Pay Range: $169800 - $219670 / year

Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Travel: No

Work Setting: Flexible

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.