Senior Director, Chief Actuary; Medicare Advantage - Kelsey - Seybold Clinics, Houston, TX

Primary Responsibilities

• Accountable for financial performance, forecasting, and margin outcomes across Medicare Advantage, Exchange, and Commercial lines of business
• Serving as Chief Actuary for a $1B+ Medicare Advantage plan, accountable for pricing strategy, bid development, and financial performance
• Owns pricing and underwriting strategy for Commercial risk contracts and capitated arrangements (120K lives, $350M revenue portfolio)
• Leads and develops actuarial and healthcare economics functions, ensuring depth of expertise aligned with enterprise needs
• Leads actuarial modeling and financial analysis for payer contract negotiations and value-based arrangements
• Accountable for monthly close actuarial outputs, including IBNR, claims projections, and variance analysis
• Owns enterprise analytics and reporting to quantify drivers of revenue, utilization, and cost trends

• BA/BS Degree in Economics, Mathematics, Actuarial Science or other related field.
• Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA)
• 10+ years of experience in data analytics, actuarial services, underwriting, or a related field inclusive of:
  • 8+ years of experience supervising or managing teams and/or projects
  • 5+ years as a Healthcare Actuary
  • 3+ years of experience with Medicare Advantage bid development
  • 3+ years of programming experience in SQL, SAS, Python or similar programming language
• Demonstrated knowledge of IBNR models
• Demonstrated knowledge of actuarial cost analysis and PMPM modeling

• Systems experience (i.e. enrollment/eligibility, capitation, claims payment, etc.) with an MCO
• Experience with reporting tools (including Crystal Reports and Microsoft Access)
• Knowledge of CMS HCC model and Risk Adjustment calculations
• Familiarity with EPIC and Clarity reporting data warehouse

Pay is based on several factors including, but not limited to, local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $159,300 to $273,200 annually based on full‑time employment.

We comply with all minimum wage laws as applicable.

Optum Care is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

Optum Care is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.