Role Summary

HIGHLIGHTS

Director-level health actuarial role focused on medical cost economics for a health plan. You will develop actuarial and financial models, drive medical cost improvement strategies, and influence cross-functional teams while managing analysts. Remote position based in the continental US with occasional travel to Pittsburgh, PA.

JOB DESCRIPTION SUMMARY

Lead medical cost economics and cost-improvement strategies for a health plan
Develop detailed actuarial and financial models and forecast results
Collaborate with clinical, network, product, finance, and payment integrity teams
Remote (work-from-home within continental US) with travel to Pittsburgh 2–3x/year
Director role managing one or more analysts; ASA or FSA and AAA membership required

DOMAIN EXPERTISE

value-based reimbursement
population health
segmentation/stratification
claims development
medical cost forecasting

KEY REQUIREMENTS

8+ years of progressive actuarial experience in health insurance/managed care/consulting
ASA or FSA certification required and American Academy of Actuaries membership required
Experience with value-based reimbursement, population health, segmentation/stratification
Data retrieval skills and relational database experience (data/analytics expertise)
Ability to work remotely within continental US and travel to Pittsburgh occasionally

TECH STACK

No tech stack specified

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead medical cost economics and cost-improvement strategies for a health plan
Develop detailed actuarial and financial models and forecast results
Collaborate with clinical, network, product, finance, and payment integrity teams
Remote (work-from-home within continental US) with travel to Pittsburgh 2–3x/year
Director role managing one or more analysts; ASA or FSA and AAA membership required

DOMAIN EXPERTISE

value-based reimbursement
population health
segmentation/stratification
claims development
medical cost forecasting

KEY REQUIREMENTS

8+ years of progressive actuarial experience in health insurance/managed care/consulting
ASA or FSA certification required and American Academy of Actuaries membership required
Experience with value-based reimbursement, population health, segmentation/stratification
Data retrieval skills and relational database experience (data/analytics expertise)
Ability to work remotely within continental US and travel to Pittsburgh occasionally