Vice President – Actuary, Medicare
Listed on 2026-06-09
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Finance & Banking
Risk Manager/Analyst, CFO, Financial Manager, Financial Consultant
Location: Remote / (travel as needed)
Reports To: Chief Financial Officer (CFO)
Position OverviewWe are seeking a strategic, high-impact actuarial leader to serve as Vice President – Actuary, Medicare. This role provides independent oversight of Medicare and government program risk, reserve adequacy, medical cost forecasting, and predictive modeling. The VP will directly advise the CFO on emerging financial risks, long-term sustainability, and enterprise strategy.
This is a high-visibility, leadership role with accountability for multi-billion-dollar revenue streams, pricing, and balance sheet reserves. The ideal candidate will combine deep technical expertise with strong business acumen, influencing key decisions across finance, product, and government programs.
Key Responsibilities- Lead actuarial oversight for Medicare, Medicaid, and other government programs, including pricing, reserving, and trend analysis.
- Assess reserve adequacy and ensure compliance with Actuarial Standards of Practice (ASOPs).
- Direct financial scenario modeling, stress testing, and cost forecasting, quantifying risk under multiple regulatory and market assumptions.
- Oversee predictive modeling for utilization, cost forecasting, high-cost claimant risk, and pricing strategy; ensure data integrity and model governance.
- Translate complex actuarial insights into actionable business recommendations for senior leadership and the Board.
- Partner with data science, analytics, and operational teams to implement and scale models effectively.
- Support long-range financial planning, rate filings, Value-Based Payment metrics, and reimbursement strategies.
- Build and mentor a high-performing actuarial team, fostering talent development and leadership succession.
- Experience
: 12–15+ years of actuarial experience in Medicare, Medicaid, or government programs. - Credentials
: ASA or FSA preferred. - Education
:
Bachelor’s degree in Actuarial Science, Finance, Mathematics, Statistics, or related field; advanced degree a plus.
- Deep technical knowledge of Medicare bidding, pricing, and risk adjustment.
- Strong leadership and team-building capability.
- Excellent communication skills; able to translate technical findings into strategic business decisions.
- Proven ability to drive process improvement, governance, and operational efficiency.
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