Director, Actuarial

City/State Norfolk, VA Work Shift First (Days) Overview: The Director, Actuarial – Government Programs will lead actuarial pricing, financial performance insights, and strategic analytics across SHP’s Medicare and Medicaid lines of business. This role is critical to ensuring market-competitive, compliant, and financially sustainable products while translating actuarial insights into actionable business decisions. This leader will operate in a highly matrixed environment, partnering closely with Finance, Product, Network, Risk Adjustment, and Clinical teams to drive enterprise value and support SHP’s growth strategy. Core Responsibilities Government Programs Pricing & Financial ManagementLead end-to-end pricing for Medicare Advantage, Medicaid, and related government programsDevelop and maintain actuarial assumptions, methodologies, and pricing modelsEnsure rate adequacy, competitiveness, and alignment with enterprise financial targetsOversee bid development, rate filings, and regulatory submissions Forecasting & Performance InsightsTranslate pricing assumptions into forward-looking financial projections and scenariosMonitor emerging experience vs. pricing assumptions and identify key drivers of varianceProvide actionable insights to improve margin, membership growth, and cost management Regulatory & Compliance LeadershipEnsure compliance with CMS, state Medicaid agencies, and insurance department requirementsSupport actuarial certifications, rate filings, and audit readinessInterface with regulators and external actuarial partners as needed Strategic Partnership & Cross-Functional LeadershipPartner with Product, Network/Provider Contracting, and Clinical teams on:Benefit design and product strategyValue-based care and provider reimbursement modelsCost of care and utilization management strategiesAlign actuarial assumptions with operational and market realities across the enterprise [202510-SHP...entity_EDJ | Word] Team Leadership & Talent DevelopmentLead and develop a high-performing team of actuaries and analystsEstablish clear priorities, governance, and quality standards for actuarial work productsFoster a culture of innovation, continuous improvement, and accountability Enterprise Contribution & Thought LeadershipContribute to enterprise planning, budgeting, and long-term strategyPresent insights and recommendations to senior leadership in a clear, actionable mannerIdentify opportunities for automation, analytics advancement, and process optimization Bachelor's Degree Required. 5 years Management. 7 years Actuarial experience. ASA required. FSA preferred. Benefits: Caring For Your Family and Your Career Medical, Dental, Vision plans Adoption, Fertility and Surrogacy Reimbursement up to $10,000 Paid Time Off and Sick Leave Paid Parental & Family Caregiver Leave Emergency Backup Care Long-Term, Short-Term Disability, and Critical Illness plans Life Insurance 401k/403B with Employer Match Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education Student Debt Pay Down – $10,000 Reimbursement for certifications and free access to complete CEUs and professional developmentPet InsuranceLegal Resources PlanColleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.