Director, Actuarial Services

About CINQCARE

CINQCARE is an innovative health and care company on a mission to eliminate barriers and to improve care in high-need, urban and rural communities. CINQCARE’s purpose is to, every day, improve the health and well-being of those who need care the most – in their homes and communities.

The Director, Actuarial Services leads CINQCARE’s actuarial function and is accountable for the integrity of the actuarial estimates, financial analytics, and performance reporting that drive enterprise decision-making. The role owns reserving and IBNR development, pricing and underwriting of risk-based arrangements, forecasting and budgeting, and risk adjustment and affordability analytics across CINQCARE’s Medicare Advantage, Medicaid, and ACO (REACH, LEAD, MSSP) portfolios.

Beyond producing analysis, the Director sets the methodology, assumptions, and standards the function operates by, builds the data and modeling infrastructure it depends on, and translates technical results into clear recommendations for the Chief Financial Officer, executive leadership, the Board, and investors. The Director also builds and develops the actuarial team, including the Senior Actuarial Analyst(s), and partners closely with Finance, Healthcare Economics, Clinical, Network, and Operations.

This position reports to the Chief Financial Officer. The Director, Actuarial Services should embody CINQCARE’s core values, including Trusted, Empathetic, Committed, Humble, Creative, and Community-Minded. Additionally, they should possess a commitment and deep conviction to CINQCARE’s purpose & mission, have healthcare experience with an understanding of value-based care, and have familiarity with or worked in early-stage companies and be equipped to support scaling with the business.

At CINQCARE, we don’t have patients or customers – we have Family Members.

The Director, Actuarial Analytics and Reporting will have the following responsibilities:

• Actuarial Ownership and Financial Reporting
  • Own the actuarial function end to end across CINQCARE’s Medicare Advantage, Medicaid, and ACO (REACH, LEAD, MSSP) portfolios, including the methodology, assumptions, controls, and documentation behind all actuarial estimates.
  • Own IBNR and reserve development; review and approve monthly reserve estimates, set completion factor and trend assumptions, and present reserve adequacy and roll-forward analysis to the CFO and external auditors.
  • Direct the actuarial contribution to monthly close and financial reporting, including IBNR and P&L development, medical expense analysis, premium/revenue analysis, and medical trend analysis.
  • Establish and defend key business assumptions with senior leadership to support monthly financial statements, rolling forecast projections, and annual budget development.
  • Proactively identify and quantify drivers of variance between actual and expected results across revenue, utilization, unit cost, risk adjustment, and quality, and recommend corrective action.
  • Serve as the actuarial point of contact for external auditors, actuarial consultants, and partner actuarial teams, and review work performed by third parties.
• Pricing, Underwriting, and Growth
  • Lead pricing and underwriting for new and renewing risk-based arrangements, including rate development, scenario and sensitivity testing, and recommendations on acceptable risk positions.
  • Own pro forma analyses and multi-year projections supporting market entry, new partnerships, and expansion of the risk and MSO business portfolios.
  • Lead the actuarial evaluation of the transition from ACO REACH to the Long-term Enhanced ACO Design (LEAD) model, including benchmark and capitation modeling, risk track selection, and multi-year financial impact.
  • Understand…