Senior Director, Actuarial – Risk Adjustment

🔥 2 minutes ago

🏄 California, Connecticut, +3 more states – Remote

🏄 California – Remote 🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote ☕ Washington – Remote

💵 $196.7k - $258.2k / year

⏰ Full Time

🟠 Senior

📊 Actuary

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Oscar Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Lead financial reporting and forecasting for ACA risk adjustment, including monthly close, external audits, regulatory reviews, and other finance-related activities • Develop strategic insights and projections regarding Oscar's ultimate risk scores and risk adjustment performance • Analyze market morbidity drivers and their financial implications, coordinating with external stakeholders including industry consultants • Lead executive-facing reporting by managing financial forecasts and presenting actuarial insights as strategic recommendations for senior leadership • Build strategic partnerships across Finance, Risk Adjustment Operations, Market P&L, Medical Economics, and Data Science • Represent the Actuarial function in executive forums • Direct advanced analytics initiatives supporting pricing, strategic business growth, and network strategies • Lead and develop a team of actuarial professionals through coaching, mentorship, and professional development • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree in a STEM field, or 4 years commensurate experience • 12+ years of quantitative analysis in the healthcare industry • 5+ years of collaborating and influencing an Executive Leadership Committee • Proven experience in a pricing role, or a related analytics-driven leadership role • Strong government programs risk adjustment subject matter expertise, preferably in ACA Marketplace • Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment • Qualified, or willing to become qualified, to serve as appointed actuary under the American Academy of Actuaries’ Specific Qualification Standard • Excellent communication, collaboration, and relationship-building skills • Strong process management skills, including streamlining workflows and driving operational efficiency • Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements • Fellow of the Society of Actuaries, or on the track to become one

🏖️ Benefits

• Employee benefits • Unlimited vacation program • Company equity grants • Annual performance bonuses • Medical, dental, and vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life and disability insurance • Paid wellness time and reimbursements