Full-Time

Actuarial Services Manager

Corporate

CareOregon

CareOregon

501-1,000 employees

Managed care with social support programs.

Compensation Overview

$170.5k - $208.3k/yr

+ 5% annual bonus

Washington, USA + 7 more

More locations: Montana, USA | Nevada, USA | Arizona, USA | Utah, USA | Wisconsin, USA | Portland, OR, USA | Idaho, USA

Remote

Work from home; occasional travel may be required.

Category
Insurance (1)
Required Skills
SAS
R
SQL
RDBMS
Financial analysis
Tableau
Excel/Numbers/Sheets

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Requirements
  • A minimum of 5 years of experience in actuarial services related to health care.
  • Work experience in health insurance.
  • Associate of the Society of Actuaries designation.
  • Extensive knowledge of managed care and the Oregon Health Plan.
  • Knowledge of various methods of estimating incurred but not reported liabilities and other reserves.
  • Ability to construct and use actuarial cost models for cost and utilization, trend, and benchmarking analysis.
  • Understanding of how to model direct and indirect financial impacts in a complex system.
  • Strong understanding of data systems and relational databases.
  • Proficiency with SAS, SQL, and/or R.
  • Advanced Excel skills.
  • Ability to develop and assess actuarial analyses and models pertaining to managed care.
  • Ability to communicate effectively verbally and in writing, including strong presentation skills.
  • Ability to develop and lead high-performing team members, including hiring, goal setting, coaching, performance management, and career development.
  • Ability to develop and maintain Tableau dashboards.
  • Ability to work with eligibility data, claims data, risk scores, and other financial data.
  • Ability to work in an environment with matrix reporting and diverse individuals and groups.
  • Ability to identify, implement, and manage process improvements.
  • Ability to learn, focus, understand, and evaluate information and determine appropriate actions.
  • Ability to accept direction and feedback, as well as tolerate and manage stress.
  • Ability to see, read, hear, speak clearly, and perform repetitive finger and wrist movements for at least 6 hours per day.
Responsibilities
  • Manage the development and communication of actuarial analyses related to financial reporting in alignment with organizational vision and goals.
  • Develop and maintain models to determine actuarial estimates of incurred but not reported liabilities, premium deficiency reserve liabilities, and other assets and liabilities, and manage regular processes to meet financial reporting deadlines.
  • Develop and maintain actuarial cost models for cost and utilization analysis, identify and explain key drivers of historical trends, and gather and develop performance benchmarks.
  • Lead trend forecasting for budgeting, collaborate with the Financial Planning and Analysis team to set utilization and cost targets, and evaluate actual results against budget.
  • Analyze financial performance and communicate historical and forecasted performance results and drivers to business leaders; identify opportunities to influence outcomes.
  • Create models of proposed interventions for goal setting, budgeting, and forecasting.
  • Oversee the design, development, and implementation of evaluation tools to measure program effectiveness and return on investment.
  • Drive the strategic use of data to support business efficiencies and competitive decision-making.
  • Ensure timely completion of regulatory reporting for the Centers for Medicare & Medicaid Services and the Oregon Health Authority.
  • Build and maintain effective relationships across internal teams and external organizations for current or future integration.
  • Partner with internal leaders and managers to identify improvement plans and processes.
  • Manage teams and recommend team direction and goals in alignment with the organizational mission, vision, and values.
  • Identify work and staffing needs, and recruit and hire employees using an equity, diversity, and inclusion lens.
  • Plan, organize, schedule, and monitor work, and ensure employees have the information and resources needed to meet job expectations.
  • Lead the development, communication, and oversight of team and individual goals, ensuring goals, expectations, and standards are understood by staff.
  • Train, supervise, motivate, and coach employees, and support employee development.
  • Ensure the team adheres to department and organizational standards, policies, and procedures.
  • Evaluate employee performance and provide regular feedback, recognize strong performance, and address performance gaps and accountability through corrective action.
  • Perform supervisory tasks in collaboration with Human Resources as needed.
Desired Qualifications
  • A minimum of 2 years of experience in a supervisory position, or a minimum of 1 year of supervisory experience with completion of CareOregon’s Aspiring Leaders Program.
  • Fellow of the Society of Actuaries designation.
  • Experience with Medicaid and Medicare.
  • Experience estimating incurred but not reported liabilities, risk adjustment transfers, and other health care liabilities and assets.
  • Experience analyzing health care cost and utilization data.

CareOregon runs a health plan in Oregon that helps hundreds of thousands of people get medical care and also funds programs that address social needs like housing, healthy food, and job training. Its product works by providing health coverage and access to services through a Member-focused program, while also financing community initiatives that support overall well-being. What sets CareOregon apart is its emphasis on social determinants of health and the wider “CareOregon Effect”—improving people’s lives beyond medical care and focusing on community impact. The company’s goal is to improve health outcomes for its members and strengthen the broader community by investing in multiple services that support stable housing, nutrition, work skills, and more.

Company Size

501-1,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Portland, Oregon

Founded

1994

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Simplify Jobs

Simplify's Take

What believers are saying

  • Tina Edlund became board chair on July 28, 2026, strengthening policy navigation.
  • Diana Cruz and Peter Lymm joined in 2026, sharpening finance and operations execution.
  • Expanded HRSN nutrition benefits and new provider tools improve member retention and claims flow.

What critics are saying

  • Jan. 1, 2027 Medicaid eligibility changes threaten membership, revenue, and program funding.
  • 2026 network cuts sever Providence and therapists, triggering member complaints and provider flight.
  • Persistent losses and 2025 layoffs signal an existential rate spiral if Oregon underfunds capitation.

What makes CareOregon unique

  • CareOregon is Oregon’s largest nonprofit Medicaid insurer, anchored by deep Oregon Health Plan relationships.
  • Its family includes Jackson Care Connect and Columbia Pacific, extending coordinated-care reach statewide.
  • It funds workforce and housing projects, like Hawk’s Eye Apartments and OHSU residency training.

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Benefits

Hybrid Work Options

Wellness Program

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Paid Vacation

PTO/vacation

Paid Holidays

Paid Sick Leave

Paid State Sick Time

401(k) Retirement Plan

401(k) Company Match

Flexible Work Hours

Remote Work Options

Pension?

Employee Assistance Program

Wellness Program

Phone/Internet Stipend

Home Office Stipend

Family Planning Benefits

Fertility Treatment Support

Stock Options

Company Equity

Conference Attendance Budget

Professional Development Budget

Mentorship Program

Tuition Reimbursement

Education allowance

Training Programs

Professional Certification Support

Legal Services

Pet Insurance

Adoption Assistance

Childcare Support

Elder Care Support

Meal Benefits

Employee Discounts

Relocation Assistance

Commuter Benefits

Meal Benefits

Adoption Assistance

Bereavement Leave

Company News

CareOregon
Jul 28th, 2026
CareOregon elects veteran policy advisor Tina Edlund as new board chair.

CareOregon elects veteran policy advisor Tina Edlund as new board chair. Published July 28, 2026 Edlund to lead Board of Directors for Oregon's largest Medicaid insurance provider with Vice Chair Dr. Jonathan Betlinski and four new members. CareOregon announced this week that Tina Edlund, a longtime state health care policy leader, has been elected as the new chair of its 17-member Board of Directors. Edlund has 25 years of experience improving access to high-quality, affordable health care for low-income Oregonians, including serving as senior health policy advisor to Gov. Kate Brown and chief of policy for the Oregon Health Authority. In those roles, she was instrumental in transforming the state's Medicaid program into a national model of coordinated care through the Oregon Health Plan. "I am honored to have been elected board chair for CareOregon," Edlund said. "This is not only a privilege, but a responsibility I take seriously." Meaningful access to patient-centered, quality health care reduces human suffering. That's the work. That's what will guide me in this role. Tine Edlund Edlund will help lead CareOregon through a period of uncertainty for Medicaid, including federal policy and eligibility changes scheduled to take effect Jan. 1, 2027. As Oregon's largest community-based, nonprofit Medicaid organization, CareOregon remains focused on protecting access to quality, equitable health care for Oregonians who rely on the Oregon Health Plan. "As a community-based nonprofit, CareOregon is governed by a dedicated, all-volunteer Board of Directors from across the state," said Eric C. Hunter, president and CEO of CareOregon. "These directors help ensure that we are good stewards of public funds and that we stay focused on our mission to support individual and community health. With the overall health care system at an inflection point and the future of Oregon's innovative models under stress, we are thrilled to have Tina Edlund begin her term as chair. Together with the full board, we are confident that CareOregon is well positioned to navigate the road ahead." Joining Edlund in board leadership as vice chair is Dr. Jonathan Betlinski, director of public psychiatry at Oregon Health & Science University. The Board also welcomed four new members in the past year: Phil Jackson, a retired health care executive; Joe McFerrin, president and CEO of Portland Opportunities Industrialization Center; Carolyn Coggins, interim senior vice president and chief financial officer at Legacy Health; and Dan Field, retired director of Multnomah County's Homeless Services Department. The Board leadership transition comes as CareOregon continues to support members, providers and community partners across Oregon's changing Medicaid landscape. "CareOregon has always shown up for its members and the community when it matters most," Edlund said. "Our job stays the same: make sure Oregonians, especially the most vulnerable among us, have access to quality care. That means we need to remain optimistic, clear-eyed and honest about the challenges in front of us."

CareOregon
May 18th, 2026
CareOregon joins American Heart Association's Torch Journey.

CareOregon joins American Heart Association's Torch Journey. Published May 18, 2026 This month, CareOregon is excited to partner with the American Heart Association (AHA) of Oregon & SW Washington on their annual Torch Journey, a tradition in which a ceremonial torch travels through the community - culminating in the Heart & Stroke Walk in Portland on June 6. The torch symbolizes unity, resilience and a shared commitment to heart health, serving as a "light in the darkness of poor health," urging community members to take action for their hearts. That spirit reflects CareOregon's ongoing work alongside local communities to address the conditions that shape health and create opportunities for people to thrive. During its 10-week journey, the torch will make several stops, including at CareOregon's downtown Portland office from May 18-29. More on the Heart & Stroke Walk. CareOregon has partnered with the AHA since 2024, sponsoring and participating in the Heart & Stroke Walk in both 2024 and 2025. This year, CareOregon, Inc. is excited to bring its largest group of walkers yet, aiming for 150 or more CareOregon employees, along with their loved ones and friends. The AHA's Heart & Stroke Walk is a premier annual fundraising and community-building event, held in over 1,000 cities nationwide, dedicated to raising funds for research and education to fight heart disease and stroke. As a family-friendly, non-competitive event, it promotes physical activity and supports initiatives like CPR training. Walkers can opt for 1-mile or 3.1-mile (5 kilometer) walks. The event also features music, speakers from local health organizations, and sponsor booths with giveaways and other heart-healthy goodies. The Heart & Stroke Walk is a major fundraising campaign, with the events raising over $200 million in 2025 to support healthier lives. The AHA is the largest non-government funder of cardiovascular research in the world. How you can get in on better heart health. To get involved in the 2026 Heart & Stroke Walk, you can: * Register to walk: You can sign up as a Coach (to create your own team), an individual walker, or as a member of an existing team. * Donate: You can select a walker or team and donate on their behalf, or opt to donate directly to the event. Proceeds go to the AHA's life-saving research on preventing heart disease and stroke, as well as community programs and advocacy efforts. As the AHA torch makes its stop at CareOregon, employees are invited to participate in a range of activities that promote heart health and well-being. These include a Cultural Health Series with AHA that highlights the importance of heart health across its communities; opportunities to register to raise funds through the Heart & Stroke Walk; a lunchtime group walk from the CareOregon office on May 28 and a Heart Wellness 10,000 steps-a-day challenge running throughout the month.

CareOregon
Feb 23rd, 2026
CareOregon welcomes Dee Cruz as Chief Finance and Strategy Officer

CareOregon welcomes dee Cruz as Chief Finance and Strategy Officer. Published February 23, 2026 CareOregon announced today that Diana (Dee) Cruz will join the organization as Chief Finance and Strategy Officer, effective February 23. Cruz brings extensive experience in health plan finance, operations and enterprise strategy. Most recently, she served as Acting President and Chief Operating Officer at WellSense Health Plan, where she oversaw strategy and operations supporting Medicare, individual and Medicaid plans serving more than 700,000 members across Massachusetts and New Hampshire. Prior to joining WellSense, Cruz initiated the Office of Consumer Obsession at Cambia Health Solutions, sponsoring enterprise programs focused on reducing consumer effort and health care costs. She previously served as Vice President of Operations at Regence Blue Cross Blue Shield and held leadership roles at Cigna across finance, operations and network architecture. "CareOregon has navigated a period that required discipline and difficult choices to ensure long-term sustainability," said Eric C. Hunter, President and CEO of CareOregon. "Dee brings strong financial leadership and strategic experience that will support our continued focus on stewardship and accountability." As Chief Finance and Strategy Officer, Cruz will oversee CareOregon's finance and enterprise strategy functions, ensuring alignment between financial performance and long-term organizational priorities. "I'm honored to join CareOregon at this important moment," said Cruz. "The organization plays a vital role in Oregon's health care system. I look forward to listening, learning and working with the team to strengthen financial stewardship and strategic alignment in support of our members."

CareOregon
Jan 26th, 2026
Strengthening Oregon's health care workforce: Preparing for tomorrow, today

Strengthening Oregon's health care workforce: preparing for tomorrow, today. The power of Medicaid at work. Across United States, health care faces a "perfect storm" of challenges - workforce shortages, rising care costs and widening disparities in health outcomes. In Oregon, these problems are amplified by a mental health crisis and limited access to care. While barriers exist statewide, they look different depending on where you live. Rural communities often face higher poverty rates and have fewer specialists, while urban areas grapple with provider burnout. CareOregon is committed to strengthening the health care workforce across Oregon, investing in programs and services that support both urban and rural communities. That commitment starts with investing in people and building a workforce pipeline that prepares future health leaders, strengthens rural health systems and supports community based care. Addressing workforce shortages isn't only about filling today's open roles. It's also about thinking ahead, preparing leaders who can prevent tomorrow's health crises and reduce strain on an overburdened system. Going upstream with the OHSU Preventive Medicine Residency program. CareOregon partnered with the Oregon Health & Science University (OHSU) to launch the Preventive Medicine Residency, a pioneering program that trains physicians for leadership roles in public health, policy and research. The program addresses workforce challenges by preparing doctors to think beyond individual patient care and focus on population-level health and prevention - essential for improving health outcomes. The Program's first cohort includes Tiantian White, MD, a family physician who grew up in rural China and saw firsthand how a lack of access to health care could have dire outcomes. "My family never had proper health care. There were so many downstream negative consequences when things became severe," Dr. White remembers. For example, her father's finger was injured and then amputated by someone without proper training. This led to an infection because it wasn't properly bandaged - resulting in a hospital stay. Experiences like this inspired White to go into preventive medicine to reduce health disparities and improve systems of care for vulnerable populations. "These are the most mission-oriented, value-driven folks I've met in my career so far," says White. "Everyone is working so hard and is passionate about what they do, despite all the looming challenges." While programs like OHSU's Preventive Medicine Residency focus on preparing physician leaders with skills and knowledge to achieve long-term public health goals, many rural communities across Oregon are currently facing more urgent and severe health care workforce shortages. Expanding rural access through Ashland Community Health Foundation. In southern Oregon, Jackson Care Connect (JCC), a coordinated care organization serving Jackson County, is part of the CareOregon family of companies. JCC partners with Ashland Community Health Foundation (ACHF) to address critical workforce gaps in the region. In this part of the state, workforce shortages can directly impact how quickly and where community members are able to receive care. Your support plays a crucial role in enhancing my efforts to foster people in recovery. Stephanie Roland, ACHF's Executive Director, says the area faces shortages at every level of the health care workforce, from medical assistants and behavioral health clinicians to specialists and emergency medical technicians (EMTs). This can lead to long wait times, even tougher to manage for the area's significant aging population. Median wait times often exceed two weeks for primary care and can reach up to 58 days for specialists. With most services concentrated in Medford, about 15 miles away, access can be especially difficult for patients without a car or reliable public transportation. I think [its nursing scholarship] will become even more important now that advanced nursing degrees are no longer deemed 'professional.' To ease pressure on emergency departments and make better use of limited capacity, ACHF is supporting a new partnership with Mercy Flights that allows EMTs to respond to 911 calls even when emergency or hospital care isn't required. Under protocols designed by Mercy Flights' medical director, eligible patients can choose to be transported to participating urgent care clinics instead of the hospital emergency department. The model helps reduce overcrowding, shortens wait times, and ensures patients receive timely, appropriate care while preserving critical resources for life-threatening emergencies. Investments from CareOregon and other donors have also helped ACHF expand behavioral health workforce pathways, including scholarships for future clinical mental health counselors, behavioral health internships, and continuing education for peer support specialists who plan to stay in the community. Together, these efforts help ensure that people who train in the region can continue serving their neighbors, which improves and strengthens access to care. Even with expanded clinical and emergency capacity, many Oregonians still need support navigating complex health systems from someone in their own community who knows what they're going through. Building community health capacity with FolkTime. Peer support specialists, community health workers and personal health navigators play a growing role in filling workforce gaps in the health care ecosystem, and can be vital partners in addressing challenges alongside traditional models of care. FolkTime is Oregon's oldest and longest-running peer-run organization, equipping individuals with the skills and tools to offer non-clinical support to peers for mental health and substance use disorder (SUD). CareOregon helps fund FolkTime's peer support specialist training program, along with the state's only personal health navigator training program providing in-person support outside of the Portland metro area, ensuring rural communities have trusted guides to help navigate complex health systems. "Rural spaces are in desperate need of trusted people in their community to help navigate complex health systems," notes Peter Starkey, Executive Director of FolkTme. "One of our focuses when it came to our commitment to equity was also geographic equity. A lot of people outside of the Portland-Salem area don't get access to professional development." For patients frustrated by provider shortages and long wait times, traditional health workers - which includes peer support specialists, community health workers and personal health navigators - can serve as a bridge and provide the support needed, right in their own community. What's more, traditional health worker training programs are often brief, allowing graduates to begin assisting community members shortly after acquiring the necessary knowledge and skills. "They are making people feel seen and heard, especially in a system where it can feel like you're not being heard," Starkey adds. The traditional health care workforce is also flexible, meaning peers can support others in a variety of settings, including within the prison system, housing services and mental health system, creating a web of support across communities. So far, FolkTime has trained over 5,000 peer support specialists in Oregon. "Connection is what cures everything - conflict, addiction, mental health struggles," Starkey emphasizes. "If we can connect with people more in our everyday lives, we'll be a much less lonely society." Why Medicaid matters in Oregon. From preventive medicine physicians to rural EMTs and peer support specialists, Medicaid helps make workforce investments like the ones highlighted here possible. By investing in innovative programs, initiatives and services like these, CareOregon is helping address today's health challenges while training the next generation of health care workers to bring tomorrow's solutions. But programs like these, many of which are relatively new, depend on stable, long-term funding - primarily from Medicaid. Changes in that funding source could cause many initiatives like these to be scaled back or disappear entirely. I don't think that philanthropy [alone] can be a solution for systems that have been eroded - it needs to be both. Investing in building and strengthening the health care workforce at every level helps ensure communities across Oregon are better equipped to meet current needs and the challenges ahead. Investments in Action series. Its "Investments in Action" series highlights the transformative power of CareOregon's strategic investments in health and wellbeing. Through these stories, CareOregon, Inc. explore how its support goes beyond traditional funding roles and is helping to close gaps in health care access and community services. Despite challenges within the Medicaid space, CareOregon, Inc. remain committed to centering these important narratives of community strength and resilience.

CareOregon
Jan 23rd, 2026
CareOregon welcomes Peter Lymm as Chief Operations Officer

CareOregon welcomes Peter Lymm as Chief Operations Officer. CareOregon announced today that Peter Lymm has joined the organization as Chief Operations Officer. Lymm brings more than 30 years of senior health care leadership experience across nonprofit health plans, provider organizations and health care technology. Most recently, he served as Western Region Market President at P3 Health Partners, where he led market-level operations and supported value-based care delivery in complex, multi-payer environments. Prior to that, he served as Chief Operations Officer at Neighborhood Health Plan of Rhode Island, a nonprofit Medicaid and Medicare health plan. "CareOregon has navigated a period that required difficult but necessary decisions to ensure long-term sustainability," said Eric Hunter, President and CEO of CareOregon. "As we move forward, strengthening our operational leadership is critical. Peter Lymm brings deep experience and a strong stewardship mindset that will support execution and stability in service of our mission." As COO, Lymm will oversee CareOregon's core operational functions, with a focus on aligning systems, teams and processes to support members and partners across Oregon. "I'm honored to join CareOregon at this important moment," said Peter Lymm. "The organization plays a vital role in Oregon's health care system. I'm looking forward to listening, learning and working alongside the team to strengthen operations and support CareOregon's long-term success."