Director, Actuarial

Core Responsibilities

• Lead end-to-end pricing for Medicare Advantage, Medicaid, and related government programs
• Develop and maintain actuarial assumptions, methodologies, and pricing models
• Ensure rate adequacy, competitiveness, and alignment with enterprise financial targets
• Oversee bid development, rate filings, and regulatory submissions
• Translate pricing assumptions into forward-looking financial projections and scenarios
• Monitor emerging experience vs. pricing assumptions and identify key drivers of variance
• Provide actionable insights to improve margin, membership growth, and cost management
• Ensure compliance with CMS, state Medicaid agencies, and insurance department requirements
• Support actuarial certifications, rate filings, and audit readiness
• Interface with regulators and external actuarial partners as needed
• Partner with Product, Network/Provider Contracting, and Clinical teams on:
• Benefit design and product strategy
• Value-based care and provider reimbursement models
• Cost of care and utilization management strategies
• Align actuarial assumptions with operational and market realities across the enterprise

Requirements

• 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
• Free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan

Schedule