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Kaiser
Pasadena, California, United States
(on-site)
Posted
1 day ago
Kaiser
Pasadena, California, United States
(on-site)
Job Type
Full-Time
Network Pricing Actuary
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Network Pricing Actuary
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
Job Summary:The Network Pricing Actuary is part of the growing Network Pricing team, which partners with the national and local market Provider Contracting teams to ensure our contract negotiations, network strategy, and understanding of our network performance are informed by reliable data and modeling.
This role serves as the regional lead, responsible for work including: coordinating and presenting analyses to influence our negotiation strategy for major deals; coordinating and performing modeling to support major negotiations; facilitating market network performance management forums, bringing insights into network performance drivers and opportunities, and driving accountability; and partnering with the provider contracting and delivery system teams to develop the network strategy. This is a leadership level role that will engage regularly with the VPs of provider contracting, the market CFOs, and the regional health plan SVP. While not having any direct reports, this role will partner closely with the network pricing analysts in the team, delegating analysis and providing guidance and coaching.
The work will require knowledge and experience of provider contracting, network strategy, and how they impact unit cost trends and product & network financial performance.
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.
- 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
- 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
- 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,Pasadena,Walnut Center - Regional Offices
Additional Locations:
- Portland
- Oakland
- Atlanta
- Rockville
- Aurora
- San Diego
- Rosemont
- Renton
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
Employee Status: Regular
Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Po/Ho Corp - MOC HealthPlan Analytics - 0308
Pay Range: $156400 - $202290 / year Kaiser Permanente is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills and geographic location along with a review of current employees in similar roles to ensure that pay equity is achieved and maintained across Kaiser Permanente. Travel: No Flexible: Work location is on-site at a KP location, with the flexibility to work from home. Worker location must align with Kaiser Permanente's Authorized States policy. 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.
Requisition #: 1417813
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Job ID: 83162305

Kaiser
California
,
United States
Kaiser Permanente's mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.
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