Director, Actuarial Services
Director of Actuarial Services (Health Plan) - Remote
As the Director of Actuarial Services, you will lead a dynamic team within the Health Plan, overseeing all Reserving functions and driving critical financial decision-making. In this strategic leadership role, you will collaborate closely with senior management to ensure the health plan's financial stability, profitability, and regulatory compliance.
Key Responsibilities:
Leadership & Team Management: Lead and mentor the Reserving team, fostering a high-performance culture and ensuring alignment with organizational goals. Provide strategic direction and oversee the execution of actuarial projects across multiple domains.
Financial Reserving & Analysis: Work with the financial reporting team to develop accurate reserves for IBNR claims, active claims, and premium deficiency, ensuring ongoing financial health and regulatory compliance.
Product Development: Support the development of pricing strategies and methodologies for the Health Plan's diverse product lines, ensuring they align with corporate goals and meet both short-term and long-term financial targets.
Underwriting Support: Partner with underwriting and sales teams to provide accurate, timely pricing tools and supporting documentation, enabling informed decision-making and efficient sales processes.
Provider Contract Evaluation: Assess and advise management on the financial implications of proposed and existing provider agreements, ensuring the organization's profitability and sustainability.
Strategic Guidance & Reporting: Provide executive leadership with insightful actuarial analyses and recommendations on key financial and operational issues, including product development, benefit changes, and pricing adjustments.
Regulatory Compliance & Filings: Collaborate with the Health Plan's Appointed Actuary to ensure timely and accurate filings of actuarial opinions and associated regulatory documents, maintaining compliance with all relevant standards.
Qualifications:
Extensive experience in actuarial services within a health plan or similar organization.
Proven leadership abilities with a focus on team development and cross-functional collaboration.
Strong analytical skills and the ability to translate data into strategic business decisions.
Expert knowledge in actuarial reserving, pricing, underwriting, and financial reporting.
Exceptional communication skills, capable of presenting complex actuarial findings to senior management and external stakeholders.
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