Chief Actuary, Jefferson Health Plans
HybridMedicaidACA ExchangeHealth OtherPricing & RatingReserving & ValuationPredictive Modelling & ML
Role Summary
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Executive health actuarial role leading pricing and reserving for government programs (Medicaid, Medicare, CHIP, ACA) based in Philadelphia. You will own pricing strategy, reserves, trend analytics, regulatory submissions, and build an in-house actuarial capability. This Chief Actuary role requires an FSA and 10+ years of health insurance actuarial leadership.
JOB DESCRIPTION SUMMARY
- Lead pricing strategy and rate development for Medicare, ACA, Medicaid, and CHIP
- Own reserving, financial forecasting, and trend analytics to support finance
- Serve as actuarial contact for state and federal regulators and filings
- Build, lead, and mentor a high-performing actuarial team
- Hybrid role based in Philadelphia (Jefferson Health Plans headquarters)
DOMAIN EXPERTISE
- leadership in Medicaid, Medicare, CHIP, and ACA programs
- pricing and reserving for health insurance products
- regulatory rate filing and submissions experience
- models for pricing, reserving, and risk adjustment
KEY REQUIREMENTS
- FSA (Fellow of the Society of Actuaries) designation required
- 10+ years of actuarial experience in health insurance with government programs
- Proven leadership in pricing, reserving, and trend analysis for Medicare/ACA/Medicaid
- Experience with regulatory rate filings and working with state/federal regulators
- Proficiency in SQL, SAS, R, Python, Excel, and VBA for actuarial modeling
TECH STACK
- Excel
