Source Job

$196,733–$286,902/yr
US Unlimited PTO

  • Lead Oscar's ACA risk adjustment actuarial function, covering financial reporting, forecasting, and strategic analysis.
  • Manage a team and partner across Finance, Risk Adjustment Operations, and Data Science to inform business strategy.
  • Translate risk adjustment performance into clear, actionable insights for senior leadership, reporting to the VP.

Risk Adjustment Financial Reporting Forecasting

6 jobs similar to Senior Director, Actuarial - Risk Adjustment

Jobs ranked by similarity.

$178,848–$260,820/yr
US Unlimited PTO

  • Own decision-making for actuarial methodologies, model enhancements, and business initiatives.
  • Oversee end-to-end actuarial pricing processes and guide strategic direction.
  • Mentor and develop actuarial team members while collaborating with cross-functional teams.

Oscar Health is a health insurance company built around a full-stack technology platform and a focus on serving members. The company values authenticity, belonging, and diversity among its employees.

$91,660–$120,303/yr
US Unlimited PTO

  • Establish and communicate accruals for monthly close processes related to IBNR claims, risk adjustment, and shared savings deals.
  • Leverage SQL and Python to expand existing frameworks, driving new insights for actuarial teams.
  • Investigate core drivers of observed trends and support regulatory filings and financial planning.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving members. Founded in 2012, Oscar fosters an authentic, inclusive culture where employees can be their most authentic selves.

US

  • Perform actuarial research, experience studies, and statistical analyses for financial forecasting and reserve valuation.
  • Calculate premiums and reserves, validate data for rate filings, and support actuarial models.
  • Support valuation by executing ALR models, investigating trends, and communicating filing status to stakeholders.

Blue Cross and Blue Shield of North Carolina is a fully taxed, not-for-profit health insurer headquartered in Durham, NC. We serve over 4.3 million members and employ more than 5,000 people passionate about making health care better for all.

US Unlimited PTO

  • Lead the strategy and execution of provider-facing risk adjustment initiatives.
  • Partner with teams like Network, Data Science, and external providers for cross-functional program delivery.
  • Analyze provider performance to identify opportunities and develop improvement plans.

Oscar is a health insurance company built around a full-stack technology platform focused on serving its members. Founded in 2012, Oscar is a sizable organization that fosters a culture of authenticity and belonging.

US Unlimited PTO

  • Own how we measure clinical outcomes across client member populations, including weight loss, A1c, blood pressure, and HEDIS measures.
  • Own Foodsmart's ROI methodology, translating clinical outcomes into economic value and identifying which member populations we help most.
  • Represent that methodology directly to payers and external actuarial and consulting firms, defending our approach under real technical scrutiny.

Foodsmart is a leading Foodcare platform in the U.S. that provides personalized clinical nutrition care, behavior change tools, and food benefits to improve health outcomes. The company serves over 3 million members, has secured a $200 million investment from TPG's Rise Fund, and maintains a customer-first, collaborative culture.

$178,848–$260,820/yr
US Unlimited PTO

  • Drive the department's strategy, program design, and implementation to enhance program value.
  • Understand competitive landscape, member needs, and healthcare trends; serve as a thought leader.
  • Lead cross-functional initiatives, manage budgeting, and develop direct reports.

Oscar is a health insurance company built around a full stack technology platform and a relentless focus on serving members. Founded in 2012, it aims to behave like a doctor in the family and supports authentic, diverse perspectives.