Accounting/Finance - Director Actuary 125-7000
Medicare AdvantageACA ExchangeCommercial Employer HealthPricing & RatingExperience StudiesReserving & Valuation
Role Summary
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Director-level health actuary role in Tulsa, OK focused on Medicare Advantage and ACA pricing, risk adjustment, and reserving. You will build an internal actuarial function, lead a team responsible for MA and ACA risk adjustment, and support pricing and large-group business. Requires deep health plan experience and strong technical skills in SAS/SQL and Excel.
JOB DESCRIPTION SUMMARY
- Lead actuarial function for Medicare Advantage and ACA in a health plan
- Own pricing, bids, and risk adjustment (RADV) for MA and ACA products
- Manage a team responsible for Medicare Advantage and ACA Risk Adjustment
- Support Large Group pricing and provider/network analytics
- Work closely with Marketing, Underwriting, Finance and external actuaries
DOMAIN EXPERTISE
- Medicare Advantage pricing and bid process
- Medicare Advantage and ACA Risk Adjustment and RADV reporting
- Large Group pricing model analysis
- IBNR, PDR and actuarial accrual development oversight
KEY REQUIREMENTS
- 8+ years of actuarial experience in health insurance
- Associate of the Society of Actuaries (ASA) required; FSA preferred
- Hands-on Medicare Advantage pricing and bid process experience
- Experience with Medicare Advantage and ACA Risk Adjustment and RADV
- Proficient with Excel and Access; experience with SAS and SQL-based tools
TECH STACK
- Excel
- Access
