About this role
<p><b>Salary Range: </b> $149,502.00 (Min.) - $201,827.00 (Mid.) - $254,152.00 (Max.)</p> <p> </p> <p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br> <br> Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br> </p> <div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Job Summary</H2> </div><div><p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">The Director, Actuarial Services is responsible for the overall management and oversight of staff for all Actuarial tasks. This position is responsible for determining the priorities of requests to Actuarial from within the company as well as from government agencies (Department of Health Care Services (DHCS), Center for Medicare and Medicaid Services (CMS), and L.A. County). Lead and support lead rates negotiations with Plan Partners, County of Los Angeles, and other major L.A. Care subcontractors. The Director responds to Government requests for data and analyses. Work with the Accounting/Finance senior management to meet financial reporting and budgeting deadlines. Provide timely assistance to Medical Payment System & Services (MPSS), Provider Network Management (PNM), Legal Enterprise Data Strategy Analytics (EDSA), and any other departments in need of Actuarial support. Summarize difficult and complex financial situations, edit and update development plans of Actuarial staff and present them to the Chief Financial Officer (CFO).</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">This position is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.</span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Duties</H2> </div><div><p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Manage staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Manage Department priorities, including workload analyses, staff availability and skill sets, system requirements, and financial impacts of requests to and demands on the Actuarial Department. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Prepare briefings, reports, consultation documents and presentations that clearly articulate L.A. Care's regulatory position and policy. Develop regulatory position and policy based on research and evidence. Improve and optimize reporting to key departments, including establishing and commutating proposed deadlines, analysis of the amounts and risks involved, project planning, and assignment of project tasks.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Direct and present completed analyses and data reports to government agencies and/or other health plans, develop plans for improved and faster data reporting.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><span>Lead in the analyses and estimated impacts of new Medi-Cal or other (Covered CA, Medicare) programs or inquiries. Lead in presenting the impact of financial changes to L.A. Care Finance and Senior Management staff, and to major subcontractors' Finance/Actuarial staff. </span></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><span>P</span></span></span><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><span>repares briefings, reports, consultation documents and presentations that clearly articulate L.A. Care's regulatory position and policy. Develop regulatory position and policy based on research and evidence.</span></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><span>Develop goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees.</span></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:'Calibri', sans-serif">Perform other duties as assigned.</span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Duties Continued</H2> </div><div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Education Required</H2> </div><div><div>Bachelor's Degree in Mathematics or Related Field</div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Education Preferred</H2> </div><div><div>Master's Degree in Mathematics or Related Field</div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Experience</H2> </div><div><p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><b>Required:</b></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">At least 8 years of actuary work experience in a health plan under the supervision of a credentialed Members of the American Academy of Actuaries (MAAA) Actuary.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">At least 6 years of experience leading staff or supervisory/management experience. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Direct involvement and extensive experience with the Finance Department's annual budgeting process, the monthly IBNR reserving process, and the annual Rate Development Template (RDT)/Special Data Request (SDR) submissions process to DHCS. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><b>Preferred:</b></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Calibri', sans-serif">Lead roles in both written and/or oral communication with the CA Dept. of Health Care Services, Dept. of Managed Health Care, the U.S. Center for Medicare and Medicaid Services, and the County of Los Angeles. </span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Skills</H2> </div><div><p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><b>Required:</b></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Thorough understanding of Actuarial Department organization and tasks, financial concepts, and Accounting principles.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Extensive knowledge of the DHCS/Mercer, Covered CA, and Medicare rating methods, as well as the related financial reporting tasks pertaining to the sources of L.A. Care revenue. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Familiarity with the capitation and other rating procedures for the major L.A. Care subcontractors, particularly involving the Medi-Cal Plan Partners and the County of Los Angeles. Direct experience in rate negotiations and presentations with these major subcontractors. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Proven skills with and superior knowledge of the annual budgeting process, the monthly financial reporting process (both Incurred but Not Reported (IBNR) and revenue debits/credits), and responding to government requests for information and explanation.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Demonstrated ability to oversee Actuarial staff in the design and construction of complex Excel spreadsheets.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Effective verbal, written and interpersonal communication skills, including proven excellence in communicating with Senior Management, outside auditors, government rate-setting staff, and other regulatory staff.</span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif"><b>Preferred:</b></span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Demonstrated ability to explain financial and actuarial concepts to non-Finance staff. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Patience and businesslike demeanor when challenged or confronted by auditors or regulators who question the work product or methods. </span></span></p> <p style="margin-bottom:2.0px;margin-top:2.0px"> </p> <p style="margin-bottom:2.0px;margin-top:2.0px"><span style="font-size:10.0pt"><span style="font-family:Calibri, sans-serif">Superior listening skills.</span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Licenses/Certifications Required</H2> </div><div><div>Associate of the Society of Actuaries (ASA)</div><div>Member of the American Academy of Actuaries (MAAA)</div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Licenses/Certifications Preferred</H2> </div><div><div>Fellow of the Society of Actuaries (FSA)</div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Required Training</H2> </div><div><p><br> Passed at least four Society of Actuaries Exams.</p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Physical Requirements</H2> </div><div><div>Light</div></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px">Additional Information</H2> </div><div><p style="margin-top:2.0px"><u><span style="font-size:10.0pt"><span><span style="font-family:Calibri, sans-serif"><b>Different Areas of Responsibilities:</b></span></span></span></u></p> <p style="margin-top:2.0px"><span style="font-size:10.0pt"><span><span style="font-family:Calibri, sans-serif"><b>Government Contracts: </b></span></span></span></p> <p style="margin-top:2.0px"><span style="font-size:10.0pt"><span><span style="font-family:Calibri, sans-serif">Responsible for the review and negotiation of Medi-Cal rates with DHCS, totally over $10B annually, as well as the development and negotiation of delegated rates of over $3B annually. </span></span></span></p> <p style="margin-top:2.0px"> </p> <p style="margin-top:2.0px"><span style="font-size:10.0pt"><span><span style="font-family:Calibri, sans-serif">As directed by the CFO, support and/or lead the review of revenue amounts from governmental agencies, especially the DHCS Medi-Cal capitation rates for assorted Medi-Cal populations and programs. </span></span></span></p> <p style="margin-top:2.0px"> </p> <p><span style="font-size:12.0pt"><span style="font-family:'Times New Roman', serif"><b><span style="font-size:10.0pt"><span style="font-family:'Calibri', sans-serif">Commercial and Medicare: </span></span></b></span></span></p> <p><span style="font-size:12.0pt"><span style="font-family:'Times New Roman', serif"><span style="font-size:10.0pt"><span style="font-family:'Calibri', sans-serif">Responsible for all Commercial and Medicare Actuarial support, over 700M in reserve estimates, risk adjustment estimates and support for various ad hoc projects across all lines of business.</span></span></span></span></p> <p> </p> </div></div></div><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.</p> <p> </p> <p><b>L.A. Care offers a wide range of benefits including</b></p> <ul> <li>Paid Time Off (PTO)</li> <li>Tuition Reimbursement</li> <li>Retirement Plans</li> <li>Medical, Dental and Vision</li> <li>Wellness Program</li> <li>Volunteer Time Off (VTO)</li> </ul> <p> </p>