Executive Director, Actuarial Services
A health insurance organization is seeking a Senior Actuarial Director to lead actuarial strategy and operations across ACA, Medicare Advantage, and Medicaid lines of business. This role focuses on pricing, CMS bid development, and aligning actuarial insights with business goals.
Responsibilities:
Lead actuarial functions for ACA, Medicare, and Medicaid products.
Oversee Medicare Advantage bid submissions, including pricing and risk adjustment.
Ensure compliance with CMS regulations and support regulatory filings.
Partner with finance, clinical, and product teams on pricing and forecasting.
Analyze cost trends and support value-based payment models.
Lead and mentor a team of actuaries and analysts.
Qualifications:
FSA designation (or near-FSA with strong experience).
10+ years in health insurance actuarial roles.
Experience with CMS bids, ACA pricing, and government program analytics.
Strong leadership, analytical, and communication skills.
Proficient in actuarial and data tools (Excel, SQL, SAS, etc.).
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