Job Description

Join to apply for the Actuary, Senior role at CareOregon

This senior level position is responsible for performing a wide variety of financial and actuarial analyses impacting strategic decision making and the company’s financial sustainability efforts. Areas of analysis include cost and utilization trend analysis, return on investment evaluations, Medicare bid development, rate setting optimization, forecasting support, benchmarking, risk adjustment optimization, provider payment evaluation, and review of actuarial estimates such as IBNR and PDR. This position provides financial stewardship by identifying opportunities for improved financial performance.

Responsibilities

• Perform financial and actuarial analyses including cost and utilization trends, profitability analytics, and evaluation tools development.
• Support rate setting and identify actuarial adjustments to rates.
• Provide cost and utilization trend recommendations and develop benchmarks for performance assessment.
• Monitor risk adjustment and evaluate provider payment models.
• Prepare risk share reports and drive data-driven strategic decisions.
• Review actuarial estimates and coordinate with outside actuaries.

Qualifications

• Associate of the Society of Actuaries required; Fellow preferred.
• Minimum 5 years’ experience in health insurance actuarial roles; Medicaid or Medicare experience preferred.

Skills & Abilities

• Proficiency in SAS, SQL, MS Excel, and MS Access.
• Strong data management, communication, and leadership skills.
• Ability to analyze complex data, lead projects, and collaborate across departments.

Additional Information

• Work environment is primarily remote, with residence required in one of the specified states.
• Salary range $135,420 - $165,520/year plus benefits and bonus.
• Candidates of color and veterans are encouraged to apply.

Job Tags

Similar Jobs