Director, Actuarial Services

Job Title:

Director, Actuary (Remote)

Department:
Actuarial Services
Location:
Remote (U.S. Based)

Overview:
A growing health plan is seeking a Director, Actuary to lead and manage actuarial initiatives across the organization. This fully remote role offers the opportunity to work with a leading health care organization, providing strategic actuarial guidance across multiple business areas. The Director will ensure excellence in actuarial services, including pricing, reserving, product development, financial forecasting, and regulatory compliance.

• Strategic Consulting: Serve as an internal actuarial consultant across business units.
• Provide expert guidance in areas such as Incurred But Not Reported (IBNR) claims, data analytics, and risk quantification.
• Actuarial Management: Supervise and develop actuarial staff to meet departmental and corporate objectives.
• Ensure the quality, accuracy, and timeliness of actuarial work products.
• Reserving & Forecasting: Partner with Financial Reporting to calculate reserves for IBNR claims, active claims, and premium deficiency reserves.
• Deliver financial forecasts and projections to support executive decision-making.
• Analyze the financial impact of new products and benefit changes.
• Establish pricing strategies, tools, and methodologies that align with strategic goals and ensure sustainable profitability.
• Underwriting &
  
  Risk Management:
  
  Collaborate with underwriting to develop pricing tools and support sales efforts.
• Enhance underwriting accuracy through robust risk assessment tools and training.
• Provider Contracting: Evaluate and report on the financial implications of provider agreements and contract modifications.
• Regulatory Compliance: Ensure compliance with federal and state rate filing requirements.
• Support statutory filings, including the Annual Statement of Actuarial Opinion.
• Business Expansion: Support the organization in exploring and entering new markets such as Stop Loss Insurance and Workers’ Compensation.

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or a related field required;
  Master’s degree preferred.
• Minimum of 8 years of progressively responsible actuarial experience in health insurance or managed care.
• Experience in both commercial and government health programs (e.g., Medicare, Medicaid).
• Strong understanding of health insurance markets and regulations, including the Medicare Modernization Act (MMA).
• Proficiency in data analysis tools, relational databases, and actuarial software.
• Exceptional analytical, problem-solving, and communication skills.

• ASA or FSA designation from the Society of Actuaries required.
• Membership in the American Academy of Actuaries required.
• Must meet applicable background check requirements.