K

Kaiser Permanente

Integrated healthcare provider and payer platform

Network Pricing Actuary

Actuarial & Risk ModellingConfirmed live in the last 24 hours
Full-timePasadena, CA, USANo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree in mathematics or a related field and at least eight years of actuarial experience are required; additional equivalent work experience in a directly related field may substitute for the degree requirement.
  • An Associate of the Casualty Actuarial Society certificate or an Associate of the Society of Actuaries certificate is required.
  • Two years of experience in a leadership role, with or without direct reports, is preferred.
  • Six years of experience with databases and spreadsheets is preferred.
  • Knowledge and experience of provider contracting, network strategy, and their impact on unit cost trends and product and network financial performance are required.

Responsibilities

  • Coordinate and present analyses to influence negotiation strategy for major deals.
  • Coordinate and perform modeling to support major negotiations.
  • Facilitate market network performance management forums, identify network performance drivers and opportunities, and drive accountability.
  • Partner with provider contracting and delivery system teams to develop network strategy.
  • Research and determine the likelihood of financial risk to the organization.
  • Align actuarial documentation with financial reports and tax returns.
  • Develop and design product line evaluations and actuarial models, and assess, analyze, and interpret financial risk and opportunity.
  • Build relationships with cross-functional stakeholders; communicate information and provide advice to drive projects forward; influence team members; respond to performance feedback; adapt to competing demands and changing responsibilities; provide feedback and mentor junior team members; create and execute development plans; and learn from change, difficulties, and feedback.
  • Conduct or oversee business-specific projects by applying subject-matter expertise; promote adherence to procedures and policies; develop work plans; determine and carry out processes and methodologies; coordinate and delegate resources; partner internally and externally on business decisions; solve complex problems; escalate issues or risks; monitor progress and results; identify improvement opportunities; and evaluate recommendations.
  • Complete actuarial documentation by reviewing and coordinating the actuarial portions of financial reports and tax returns and responses to insurance regulations, and present results internally to mid-level leadership.
  • Develop and design product line evaluations by interpreting and communicating analysis findings on product line financials, reserves, valuation, and cash flow, and interpreting product line performance, risk, and product-development assumptions.
  • Design and develop actuarial research by creating complex methods to advance standards, assumptions, and the legal and regulatory environment.
  • Assess, analyze, and interpret financial risks and opportunities using non-traditional actuarial methods and actuarial judgment.
  • Lead collaboration with business partners by translating complex actuarial constructs into actionable recommendations and formulating accurate actuarial and financial advice in compliance with the Actuarial Standards of Practice.
  • Create frameworks and assumptions for new, existing, and non-traditional actuarial models to meet business needs.

About the Company

Kaiser Permanente

Integrated healthcare provider and payer platform

Kaiser Permanente runs an integrated healthcare platform that lets members manage and pay medical, premium, and pharmacy bills online. It serves Medicare Advantage, Individual and Family, and non-employer plans, offering options to pay as a guest or set up payment plans. The platform works by presenting a centralized online portal where users can view bills, choose how to pay, and handle multiple types of charges in one place. Revenue comes from premiums and medical services fees, while the service aims to reduce administrative work for both providers and patients and encourage on-time payments. What sets Kaiser Permanente apart is its combination of healthcare services with a single billing experience across multiple plan types, focusing on a user-friendly, centralized payment process rather than handling billing through separate systems. Its goal is to provide a straightforward, reliable way for members to manage and pay their bills, improving convenience and payment timeliness.

Company size
10,001+
Company stage
Grant
Total funding
$7.5M
Headquarters
Oakland, CA
Founded
1945

Recently Posted Jobs

Explore more opportunities at Kaiser Permanente

See more jobs