Executive Director, Actuary
About the Company
Reputable healthcare organization
Industry
Health, Wellness and Fitness
Type
Privately Held
About the Role
The Company is seeking an Executive Director, Actuary to play a pivotal role in driving and supporting the company's strategy. The successful candidate will be responsible for managing actuarial expertise to ensure actuarial soundness and using actuarial knowledge and tools to enhance the profitability of health plan lines of business. This includes monitoring claims trends, investigating aberrations, tracking member risk scores for risk adjustment analysis, and conducting ongoing analysis of utilization trends. The role also involves assisting in various actuarial filings, coordinating with external consultants and internal staff, and supporting the annual budget process. The ideal candidate will have a strong background in the actuarial industry, particularly in healthcare, and experience with managed care and state/federal government programs. Candidates for the Executive Director, Actuary position at the company should have a Bachelor's degree in Actuarial Science, Mathematics, or Finance, with a minimum of 5 years' experience in the actuarial industry, specifically in healthcare. A background in Medicaid, commercial, and/or MA business, including rate negotiations, design, and state and federal reporting requirements, is essential. The role requires proficiency in Excel, computer coding (SQL/SAS), and strong analytical skills in medical claims trends, reserving, forecasting, and pricing. The ability to communicate complex analytical results effectively and provide guidance to entry-level staff is also necessary. While not mandatory, an Associate of the Society of Actuaries (ASA) and Membership in the American Academy of Actuaries (MAAA) are preferred. Experience with state or federal regulators, CMS, or other external regulatory entities is a plus.
Travel Percent
Less than 10%
Functions
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