VP, Chief Actuary

Job not on LinkedIn

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $156.1k - $375.5k / year

⏰ Full Time

🔴 Lead

📊 Actuary

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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PacificSource Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Lead enterprise actuarial strategy and advise executive leadership and the Board on pricing, financial risk, market trends, capital requirements, growth opportunities, and long-term financial performance • Direct actuarial functions across pricing, forecasting, reserving, trend analysis, risk modeling, underwriting support, financial performance evaluation, and scenario modeling • Ensure sound premium development, IBNR reserves, Statements of Actuarial Opinion, regulatory certifications, and compliance with actuarial standards • Monitor healthcare utilization, cost trends, and emerging risks and recommend mitigation strategies • Lead actuarial support for Enterprise Risk Management, Own Risk and Solvency Assessment, and related risk activities • Maintain relationships with regulators, auditors, rating agencies, and consulting actuaries • Lead actuarial evaluation, pricing, and financial impact analysis for products, benefit designs, regulatory changes, market opportunities, and healthcare delivery models • Partner with Product Development, Sales, Marketing, Government Programs, and other leaders on competitive positioning and strategic growth • Support value-based reimbursement arrangements, risk-sharing agreements, provider incentive programs, and alternative payment models • Analyze provider performance, quality outcomes, cost trends, and clinical program effectiveness • Oversee actuarial analytics, predictive modeling, business intelligence, and data-driven insights • Collaborate with data and technology teams on analytical capabilities, modernization initiatives, and executive reporting • Lead, coach, and develop actuarial and underwriting staff, including staffing, performance management, succession planning, and talent development • Build a high-performing culture while managing departmental operating and capital budgets • Oversee administrative budget planning, expense forecasting, variance analysis, and resource allocation • Partner with Accounting and oversee FP&A for financial planning, budgeting, forecasting, reporting, cost-benefit analysis, and strategic initiative impact evaluation • Participate in strategic and internal committees • Meet department and company performance and attendance expectations • Follow privacy policy and HIPAA requirements for protected health information • Perform other duties as assigned • Travel approximately 5% of the time

🎯 Requirements

• At least 10 years of progressive actuarial leadership experience within healthcare, health insurance, managed care, or related industries • At least 4 years in a leadership role • Experience with Medicare Advantage, Medicaid, ACA Marketplace, and risk adjustment programs • Experience supporting value-based care and alternative payment models • Experience managing multiple actuarial disciplines and business functions • Baccalaureate degree in business, mathematics or a related field • Active member in good standing of American Academy of Actuaries • Fellow of the Society of Actuaries (FSA) • Thorough knowledge of generally accepted actuarial principles • Knowledge and responsibility for performing actuarial projections, ratings, and recommendations • Creativity and innovative problem solving • Ability to justify analysis and recommendations with sound logic and actuarial principles • Ability to work inside in a general office setting with ergonomically configured equipment • Ability to stoop and bend, sit and/or stand for extended periods, and perform repetitive motions • Ability to perform light lifting and carrying of files and business materials • Ability to read and comprehend both written and spoken English • Ability to communicate clearly and effectively

🏖️ Benefits

• Equal opportunity employment • Professional development • Coaching and developing others • Approximately 5% travel