Closer to a lean-team generalist than a specialist centre of excellence because one leader owns the full actuarial function while the business scales.
Director-level Health actuarial role in Washington, DC, leading actuarial services across Medicare Advantage, Medicaid, and ACO portfolios. You will own reserving, pricing, forecasting, risk adjustment, financial reporting, and analytics while advising the CFO, Board, investors, and deal teams. The role manages and develops the actuarial team and requires an ASA or FSA, 10+ years of healthcare actuarial experience, and 5+ years of leadership.
Requirements
Must have
Bachelor's degree in a STEM field
ASA or FSA designation
10+ years actuarial/financial experience with substantial healthcare actuarial experience
5+ years progressive leadership/management experience including direct management
Deep experience across IBNR/reserving, pricing/underwriting, forecasting/budgeting, trend analysis
Experience in risk-based arrangements including Medicare Advantage, Medicaid, ACO models
Hands-on fluency with large healthcare datasets (claims, encounter, enrollment, Medicare Advantage/ACO sources)
Working knowledge of risk adjustment (HCC/RAF) and claims coding/grouping logic
Superior Excel, SQL/SAS/Python, Word, PowerPoint skills
Excellent communication skills with executive and Board presentation experience
Ability to translate complex data into actionable insights
Strong collaboration, project management, time management, prioritization, delegation skills
Strong organizational and problem-solving skills, good judgment under incomplete information
Ability to maintain high degree of confidentiality and discretion
Nice to have
MAAA membership (preferred)
Skills & Domain
ToolsExcel
DomainHealthcare actuarial experience in health insurance, consulting, or value-based careIBNR reserving, pricing, forecasting, and trend analysis for health plansRisk-based arrangements in Medicare Advantage, Medicaid, and ACO modelsRisk adjustment (HCC/RAF) and claims coding analytics
