VP, Chief Actuary

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $156.1k - $375.5k / year

⏰ Full Time

🔴 Lead

📊 Actuary

👻 Ghost score 0%

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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 actuarially sound premium development, IBNR reserves, Statements of Actuarial Opinion, regulatory certifications, and compliance with actuarial standards of practice • 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 other risk activities • Ensure compliance with state and federal regulatory requirements, accreditation requirements, and actuarial standards • 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 evolving healthcare delivery models • Partner with leaders across Product Development, Sales, Marketing, Government Programs, and other functions to support strategic growth • Develop and evaluate 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 culture of accountability, collaboration, innovation, and continuous improvement • Manage 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 PacificSource privacy policy and HIPAA laws and regulations • Perform other duties as assigned

🎯 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 typing, sorting and filing • Ability to lightly lift and carry files and business materials • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively

🏖️ Benefits

• Equal opportunity employment • Travel required approximately 5% of the time