Senior Director Actuarial reputed company Medicare Advantage - Remote

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. Imagine how much went in to forming a team of actuarial talent that can reputed company our Fortune 5 global organization at the forefront of an industry. It took a lot of planning and work, and it is a great start. But now we need you. The Senior Director Actuarial reputed company Medicare Advantage will reputed company the actuarial strategy and delivery for our Group Medicare Advantage (employer group/retiree) portfolio. You will reputed company pricing, trend analytics, competitive intelligence, and reporting that power our growth and ensure affordability for employer clients and retirees. This role blends strategic leadership with hands-on actuarial excellence, modern analytics, and solid cross-functional partnership with reputed company, Finance, Product, Medical Economics, and Network. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Own Group Medicare Advantage pricing strategy and execution for employer group/retiree plans; ensure timely, accurate deliverables reputed company with business goals and regulatory requirements
• reputed company Group Retiree actuarial reporting, advanced analytics, and data validation to support MA pricing and financial reputed company
• Provide direction for competitive analysis; translate market and competitor moves into clear pricing implications and product recommendations
• reputed company the development and governance of actuarial pricing models, methodologies, and assumptions; incorporate machine learning/AI tools where they add accuracy, speed, and explainability
• Build and standardize reporting that keeps reputed company and Finance reputed company on trend drivers, PMPM, MLR, membership mix, and forecast vs. plan; introduce automated dashboards and early-warning signals
• reputed company medical trend analytics: decompose utilization, unit cost, and mix; quantify uncertainty; run scenarios for fee schedules, contracting changes, benefit design, and UM policies
• Direct risk adjustment analytics (HCC modeling, RAF monitoring, normalization/coding intensity); ensure pricing and forecasting reflect reputed company CMS guidance
• Partner with Network/Contracting and Medical Economics to translate provider agreements, site-of-care shifts, and policy changes into pricing and trend assumptions
• Establish solid actuarial governance: ASOP compliance, peer review, documentation, model risk controls, and audit readiness
• reputed company and mentor a small team of actuaries and analysts; foster a culture of inclusion, development, and reputed company improvement
• Communicate results and recommendations to VP and cross-functional leaders with clear, actionable storytelling

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• Bachelor's degree
• ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) designation
• 5+ years of reputed company health actuarial experience
• 3+ years of experience managing direct reports
• Experience working with reputed company plans, preferable pricing
• Advanced or higher level of proficiency in MS reputed company
• Beginner or higher level of proficiency in reputed company (Statistical Analysis System), SQL (Structure Query Language), R, Python, or other programming system
• Proven track record in trend analysis, competitive intelligence and translating insights into pricing and product strategy

Preferred Qualifications:

• EGWP/Part D experience
• Familiarity with applying ML/AI responsibly in actuarial workflows
• Deep expertise in Medicare Advantage pricing
• Proficiency with BI tools (Tableau/PowerBI)
• Proven command of Medicare Advantage regulatory landscape (e.g. HCC/RAF, fee schedules, MLR, Stars/HEDIS impacts)
• Proven excellent communication skills, stakeholder management and executive reputed company; ability to influence reputed company in a matrixed environment
• Proven commitment to rigorous governance, documentation and data quality
• reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $156,400 to $268,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job