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Senior Director, Actuarial - Risk Adjustment

Oscar Health

Health/Insurer/VP Level

Senior Director, Actuarial - Risk Adjustment

Oscar Health

New York, United States · Remote · 6d ago

Salary
$197k - $287k
Experience
12+ Years

Role Summary

Role type

Specialist in a carrier actuarial function

Closer to a carrier specialist role than capital strategy: the remit is a defined ACA risk adjustment function rather than enterprise capital, ERM, or ORSA.

Senior Director health actuarial role focused on ACA Exchange risk adjustment in a fully remote U.S. position. You will lead financial reporting, forecasting, risk-score and morbidity analysis, executive reporting, and strategic analytics while managing an actuarial team and partnering across Finance, Operations, Medical Economics, and Data Science. The role requires 12+ years of healthcare quantitative analysis and reports to the VP, Corporate Actuarial.

Requirements

Must have

  • 12+ years of quantitative analysis in the healthcare industry
  • 5+ years of collaborating and influencing an Executive Leadership Committee
  • Proven experience in a pricing role, or a related analytics-driven leadership role
  • Strong government programs risk adjustment subject matter expertise, preferably in ACA Marketplace
  • Bachelor's degree in a STEM field, or 4 years commensurate experience

Strongly preferred

  • Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment
  • Qualified (or willing to become qualified) to serve as appointed actuary for insurance companies per the American Academy of Actuaries' qualification standard
  • Fellow of the Society of Actuaries (SOA), or on the track to become one
  • Excellent communication, collaboration, and relationship-building skills
  • Strong process management skills, with experience streamlining workflows and driving operational efficiency
  • Collaborative and influential leadership style, with experience partnering across multiple teams and stakeholders
  • Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements

Skills & Domain

DomainACA risk adjustmentGovernment programs risk adjustmentHealthcare quantitative analysisExecutive leadership collaboration