Chief Actuary Medicare Advantage Senior Director

Explore opportunities with Kelsey-Seybold Clinic
, part of the Optum family of businesses
. Work with one of the nation’s leading health care organizations and build your career across more than 40 locations throughout Houston. Be part of a team nationally recognized for delivering coordinated, accountable care.

As a multispecialty clinic, we provide care through more than 900 medical providers across 65 specialties. Take on a rewarding opportunity to help drive higher quality, improved patient satisfaction, and lower total costs. Join us and discover the meaning behind

Caring. Connecting. Growing together.

Kelsey-Seybold Managed Care Analytics (MCA) exists to monitor and improve the financial performance of Kelsey-Seybold (KS) by providing actionable, data-driven insights. Within MCA, the primary focus of the Actuarial Services and Healthcare Economics teams is to apply actuarial rigor to pricing, forecasting, and broader analytical initiatives.

The Senior Director serves as the Chief Actuary and enterprise financial leader responsible for the performance of Kelsey-Seybold’s $1B+ Medicare Advantage health plan and broader commercial risk-bearing lines of business, impacting more than 200K risk lives. This role has end-to-end accountability for pricing, underwriting, revenue forecasting, claims cost projections, and margin performance, as well as leadership of the Healthcare Economics (HCE) function.

This leader drives enterprise trend strategy, financial planning, and risk-based contracting, directly influencing payer negotiations, product strategy, and affordability initiatives. The role partners with executive leadership to optimize total cost of care, ensure actuarial and financial integrity, and deliver sustainable growth across Medicare Advantage, Exchange, and Commercial lines of business.

• Accountable for financial performance, forecasting, and margin outcomes across Medicare Advantage, Exchange, and Commercial lines of business
• Serves 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

You’ll be rewarded and recognized for your performance in an environment that challenges you while providing clear direction on what it takes to succeed in your role, as well as development opportunities for future roles of interest.

• BA/BS degree in Economics, Mathematics, Actuarial Science, or a 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, including:
• 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 a similar programming language
• Demonstrated knowledge of IBNR models
• Demonstrated knowledge of actuarial cost analysis and PMPM modeling

• Systems experience (e.g., enrollment/eligibility, capitation, claims payment) within an MCO
• Experience with reporting tools, including Crystal Reports and Microsoft Access
• Knowledge of CMS HCC models 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 market conditions, education, work experience, and certifications. In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase…