VP, Chief Actuary
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Job Description
Chief Actuary leading PacificSource’s health-plan pricing, risk, and financial strategy. Overseeing actuarial teams, forecasting, regulatory 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 sound premium development, IBNR reserves, Statements of Actuarial Opinion, regulatory certifications, and compliance with actuarial standards
- 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
- Ensure compliance with state and federal regulations, accreditation requirements, and actuarial standards
- 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, and executive reporting
- Provide leadership, coaching, and professional development for actuarial and underwriting staff
- Manage culture, departmental operating and capital budgets, expense forecasting, variance analysis, and resource allocation
- Partner with Accounting and oversee FP&A for financial planning, budgeting, forecasting, reporting, and cost-benefit analysis
- Participate in strategic and internal committees
- Meet department and company performance and attendance expectations
- Follow privacy policy and HIPAA requirements for protected health information
- 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 stoop and bend, sit and/or stand for extended periods, and perform repetitive typing, sorting, and filing
- Ability to lightly lift and carry files and business materials
- Ability to read and comprehend written and spoken English
- Ability to communicate clearly and effectively
Benefits:
- Equal opportunity employment
- Travel approximately 5% of the time
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