Director, Actuarial Services
Employment Information
Job Description
Director of Actuarial Services leading strategic initiatives within Peak Health. Guiding development and execution of actuarial functions for pricing, reserving, and decision-making.
Responsibilities:
- Consistently work with senior leadership by providing balanced actuarial insights and support strategic decision-making.
- Act as a subject matter expert on actuarial matters in cross-functional meetings.
- Manage teams both internally and externally to support business objectives.
- Lead and oversee governmental product rate setting processes to ensure accuracy, compliance, and alignment with organizational strategy.
- Maintain financial models where appropriate to support decision making.
- Provide accurate and timely financial information for organizational planning.
- Assess and manage financial risks related to insurance products, payment models and other financial instruments.
- Develop effective strategies to be aware of regulatory changes.
- Train and develop colleagues as needed.
- Manage and coordinate commercial rate filings, including preparation, review, and submission.
- Direct repricing initiatives for self-funded clients to maintain competitiveness and financial sustainability.
- Guide and support underwriting activities for fully insured clients, ensuring sound risk assessment and pricing strategies.
- Develop and monitor reinsurance arrangements to optimize financial protection and risk management.
- Oversee monthly financial accruals for incurred but not reported (IBNR) claims, ensuring timely and accurate reporting.
- Analyze and report on product gross margin performance to drive strategic decision-making.
- Design, implement, and evaluate value-based product models, including ongoing performance monitoring.
- Negotiate and manage contracts to support organizational goals and maintain strong business partnerships.
Requirements:
- Bachelor's degree in actuarial science, mathematics, data science, finance, statistics, economics, or related field.
- ASA designation from the Society of Actuaries.
- Eight (8) years of progressive healthcare actuary leadership experience, including direct prior experience with healthcare claims data, partner/provider analytics, payer-provider contracting, and/or value-based care.
- Two (2) years of experience managing a team.
- FSA designation from the Society of Actuaries (preferred).
- Medicare Advantage bid pricing experience (preferred).
- Membership in the American Academy of Actuaries (preferred).
Benefits:
- Standard Office Environment
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