Director, Actuarial

The Director, Actuarial – Government Programs will lead actuarial pricing, financial performance insights, and strategic analytics across SHP’s Medicare and Medicaid lines of business. This role is critical to ensuring market-competitive, compliant, and financially sustainable products while translating actuarial insights into actionable business decisions.

This leader will operate in a highly matrixed environment, partnering closely with Finance, Product, Network, Risk Adjustment, and Clinical teams to drive enterprise value and support SHP’s growth strategy.

• Lead end-to-end pricing for Medicare Advantage, Medicaid, and related government programs
• Develop and maintain actuarial assumptions, methodologies, and pricing models
• Ensure rate adequacy, competitiveness, and alignment with enterprise financial targets
• Oversee bid development, rate filings, and regulatory submissions

• Translate pricing assumptions into forward-looking financial projections and scenarios
• Monitor emerging experience vs. pricing assumptions and identify key drivers of variance
• Provide actionable insights to improve margin, membership growth, and cost management

• Ensure compliance with CMS, state Medicaid agencies, and insurance department requirements
• Support actuarial certifications, rate filings, and audit readiness
• Interface with regulators and external actuarial partners as needed

• Partner with Product, Network/Provider Contracting, and Clinical teams on:
  • Benefit design and product strategy
  • Value-based care and provider reimbursement models
  • Cost of care and utilization management strategies
• Align actuarial assumptions with operational and market realities across the enterprise

• Lead and develop a high-performing team of actuaries and analysts
• Establish clear priorities, governance, and quality standards for actuarial work products
• Foster a culture of innovation, continuous improvement, and accountability

• Contribute to enterprise planning, budgeting, and long-term strategy
• Present insights and recommendations to senior leadership in a clear, actionable manner
• Identify opportunities for automation, analytics advancement, and process optimization

• Bachelor's Degree Required.
• 5 years Management experience.
• 7 years Actuarial experience.