Senior Director, Actuarial – Risk Adjustment

This is a fully remote position, open to applicants in California, +4 more states.

📋 Description

• Oversee financial reporting and forecasting for ACA risk adjustment, which includes monthly closing, external audits, regulatory assessments, and various finance-related tasks.

• Create strategic insights and forecasts pertaining to Oscar's ultimate risk scores and risk adjustment outcomes.

• Examine market morbidity factors and their financial consequences while collaborating with external partners, including industry consultants.

• Manage executive-level reporting by overseeing financial forecasts and presenting actuarial insights as strategic recommendations for senior management.

• Establish strategic alliances across Finance, Risk Adjustment Operations, Market P&L, Medical Economics, and Data Science.

• Act as the representative for the Actuarial function in executive discussions.

• Direct advanced analytics projects that support pricing, strategic business development, and network strategies.

• Lead and nurture a team of actuarial professionals through coaching, mentorship, and opportunities for professional growth.

• Execute additional duties as assigned.

⛳️ Requirements

• Bachelor's degree in a STEM discipline, or 4 years of equivalent experience.

• A minimum of 12 years of experience in quantitative analysis within the healthcare sector.

• At least 5 years of experience working with and influencing an Executive Leadership Committee.

• Demonstrated experience in a pricing position, or in a leadership role that relies heavily on analytics.

• Strong expertise in government programs risk adjustment, particularly within the ACA Marketplace.

• Substantial experience in leading actuarial financial reporting, including claims reserving and risk adjustment.

• Qualified, or willing to become qualified, to act as an appointed actuary under the American Academy of Actuaries’ Specific Qualification Standard.

• Exceptional communication, collaboration, and relationship-building abilities.

• Strong skills in process management, including optimizing workflows and enhancing operational efficiency.

• Thorough understanding of ACA-specific healthcare laws, regulations, and compliance obligations.

• Fellow of the Society of Actuaries, or on the path to achieving this designation.

🏝️ 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