VP, Chief Actuary

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Job Description

Chief Actuary leading PacificSource’s health-plan actuarial strategy, pricing, risk, and analytics. Advising executives and the Board on growth, compliance, capital, and affordability.

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 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 and recommend 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 products, benefit designs, regulatory changes, market opportunities, and healthcare delivery models
  • Partner with Product Development, Sales, Marketing, Government Programs, and other leaders on competitive positioning and strategic growth
  • Support 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
  • Provide leadership, coaching, professional development, staffing, performance management, succession planning, and talent development for actuarial and underwriting staff
  • Build a high-performing culture while managing 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
  • 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 read and comprehend both written and spoken English
  • Ability to communicate clearly and effectively
  • Ability to meet performance and attendance expectations
  • Ability to follow privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information

Benefits:

  • Equal opportunity employment
  • Travel required approximately 5% of the time