VP, Chief Actuary
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Job Description
Chief Actuary leading PacificSource’s health insurance pricing, risk, and financial strategy in Florida. Directing actuarial teams, forecasting, underwriting, compliance, and value-based care analysis.
Responsibilities:
- Lead enterprise actuarial strategy and advise executive leadership and the Board on pricing, financial risk, market trends, capital requirements, growth opportunities, and long-term financial performance
- Direct actuarial functions across pricing, forecasting, reserving, trend analysis, risk modeling, underwriting support, financial performance evaluation, and scenario modeling
- Ensure actuarially sound premium development, IBNR reserves, Statements of Actuarial Opinion, regulatory certifications, and compliance with actuarial standards of practice
- Monitor healthcare utilization, cost trends, and emerging risks; recommend financial risk mitigation strategies
- Lead actuarial support for Enterprise Risk Management, Own Risk and Solvency Assessment, and other risk activities
- Maintain relationships with regulators, auditors, rating agencies, and consulting actuaries
- Lead actuarial evaluation, pricing, and financial impact analysis for new products, benefit designs, regulatory changes, market opportunities, and healthcare delivery models
- Support competitive positioning and strategic growth across Individual, Medicare Advantage, Medicaid, and Commercial markets
- Develop and evaluate value-based reimbursement arrangements, risk-sharing agreements, provider incentive programs, and alternative payment models
- Analyze provider performance, quality outcomes, cost trends, and clinical program effectiveness
- Oversee actuarial analytics, predictive modeling, business intelligence, and data-driven insights
- Collaborate with data and technology teams on analytical capabilities, modernization initiatives, and executive reporting
- Lead, coach, and develop actuarial and underwriting staff, including staffing, performance management, succession planning, and talent development
- Build a culture of accountability, collaboration, innovation, and continuous improvement
- Manage departmental operating and capital budgets
- Oversee administrative budget planning, expense forecasting, variance analysis, and resource allocation
- Partner with Accounting and oversee FP&A for financial planning, budgeting, forecasting, performance reporting, cost-benefit analysis, and strategic initiative impact evaluation
- Participate in strategic and internal committees
- Meet department and company performance and attendance expectations
- Perform other duties as assigned
Requirements:
- At least 10 years of progressive actuarial leadership experience within healthcare, health insurance, managed care, or related industries
- At least 4 years in a leadership role
- Experience with Medicare Advantage, Medicaid, ACA Marketplace, and risk adjustment programs
- Experience supporting value-based care and alternative payment models
- Experience managing multiple actuarial disciplines and business functions
- Baccalaureate degree in business, mathematics or a related field
- Active member in good standing of American Academy of Actuaries
- Fellow of the Society of Actuaries (FSA)
- Thorough knowledge of generally accepted actuarial principles
- Knowledge and responsibility for performing actuarial projections, ratings, and recommendations
- Creativity and innovative problem solving
- Ability to justify analysis and recommendations with sound logic and actuarial principles
- Ability to work inside in a general office setting with ergonomically configured equipment
- Ability to stoop and bend, sit and/or stand for extended periods, and perform repetitive motions including typing, sorting and filing
- Ability to perform light lifting and carrying of files and business materials
- Ability to read and comprehend written and spoken English
- Ability to communicate clearly and effectively
- Must follow PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
Benefits:
- Equal opportunity employment
- Professional development
- Travel opportunities approximately 5% of the time
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