JOB DESCRIPTION

Job Summary

Manages a process that blends standard actuarial modeling, medical economics, and financial reporting and analytics. Analyzes data for cost savings opportunities and performance improvement initiatives. Evaluates healthcare utilization and claims experience to identify areas of growth in coordination with health plan operational management. Collaborates with the Kentucky Finance, and corporate actuarial teams on IBNR calculations, capitation rate review, rate advocacy, and forecasting.

Job Duties

• Collaborate with Actuarial staff to perform IBNR estimates and rate adequacy studies.

• Analyze results to identify early signs of trends or other issues related to medical care cost.

• Design and perform actuarial studies related to medical care costs and trends.

• Research and develop reports and analysis for senior management, effectively presenting and communicating results.

• Works closely with operational management to identify saving opportunities and areas of medical utilization concerns.

• Provide support to financial closing process regarding estimated settlements and risk corridor calculations.

• Pricing and tracking of capitation arrangements.

• Stay abreast of professional developments and industry trends.

• Provide guidance and mentorship to staff member.

JOB QUALIFICATIONS

REQUIRED EDUCATION:

Bachelor’s Degree

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

Minimum 6 years of experience in addition to leadership experience

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

Must have passed at least 4 actuarial exams.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

ASA or near ASA

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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Pay Range: $88,453 - $206,981 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.