Lead Data Analysis and Actuarial Reporting

Job Summary

The Lead Data Analysis and Actuarial Reporting is responsible for leading complex data analysis and reporting initiatives that support regulatory submissions and internal decision-making. This position focuses on the preparation and analysis of healthcare experience reports for agencies such as the Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and Covered California. The Lead provides key stakeholders with timely, accurate, and actionable data insights to support strategic planning, compliance, and financial forecasting. Leads and works closely with assigned team daily.  This position will mentor, coach, and may provide feedback to management on performance of staff.  Ensure team effectiveness and project completion.

Duties

Design and produce reports and dashboards that support regulatory and business needs.

Analyze healthcare cost and utilization data to identify trends and support pricing strategies.

Prepare and document submissions such as Rate Development Templates and Special Data Requests.

Collaborate with stakeholders to define data requirements and deliver actionable insights.

Consolidate and interpret data across business areas to support financial forecasting and strategic planning.

Provide key stakeholders with accurate data and analysis to support compliance, litigation, and rate-setting activities.

Ensure data accuracy, integrity, and compliance with regulatory standards.

Participate in cross-functional projects and contribute to process improvement initiatives.

Communicate findings and recommendations to key stakeholders.

Lead the work of assigned staff; regularly assign and check the work of others, providing guidance, training and feedback on performance to department management.  Assist management in the oversight of the daily office workflow, recommend enhancements to process and procedures.

Guide the assigned staff in ensuring that the team's work is completed effectively.  May assist in the assigning tasks and communicating project goals.

Responsible for the day-to-day execution and implementation of projects and tasks. Facilitate team dynamics, motivate assigned staff and foster an environment conducive to effective collaboration and productivity.

Provide direct guidance, instruction and support specific projects or tasks.

Participate in team problem-solving, decision-making, and conflict resolution.

Manage complex projects, engaging and updating key stakeholders, developing timelines, lead others to complete deliverables on time and ensure implementation upon approval.

Perform other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 4 years of health care data analysis experience.

At least 3 years of experience in Medi-Cal Rate Development Template (RDT) submissions.

At least 1 year of leading process, program, or staff experience.

Analytical programming experience (e.g. SQL, Oracle, or other Business Intelligence tools).

Preferred:

Experience with managed health care plans data retrieval and analysis. 

Experience with Supplemental Data Requests from DHCS.

Skills

Required:

Strong understanding of healthcare cost structures and industry practices.

Excellent analytical and problem-solving skills.

Ability to interpret complex data and develop actionable insights.

Familiarity with regulatory requirements and reporting standards.

Excellent verbal and written communication, conflict resolution, motivational, and collaboration skills.

Ability to manage multiple priorities and meet deadlines.

Proficient in SQL, SAS, Python/R, and business intelligence reporting tools.

Exceptional attention to detail and critical-thinking skills.

Ability to work closely with a team in a collaborative and interactive environment.

Skilled in fostering teamwork and collaboration.

Ability to adjust to changing circumstances within the team. 

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information