Director of Actuarial Analytics

Job Summary

Leading health plan and risk adjustment analytics, the full-time remote Director of Actuarial Analytics will build member-level actuarial models, develop analytics for rate-setting, and communicate findings to both actuarial and non-actuarial stakeholders.

Key responsibilities

• Build and maintain member-level actuarial models for risk adjustment performance and medical economics
• Develop analytics to support rate-setting for various Medicare and Medicaid programs
• Communicate model methodology and results clearly to customer executives and non-actuarial audiences

Required qualifications

• Seven or more years of actuarial or actuarial-adjacent analytics experience in health plan pricing or risk adjustment
• Direct pricing or performance modeling experience across Medicare Advantage, MAPD, ACA, or Medicaid
• Working knowledge of CMS-HCC and ACA risk models, including RAF score calculation
• Demonstrated experience building member-level data models for reporting or dashboard tools
• Bachelor's degree in actuarial science, mathematics, statistics, economics, or a related quantitative field