Director, Actuarial

Role Description

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 Management
  • 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
• Forecasting & Performance Insights
  • 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
• Regulatory & Compliance Leadership
  • 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
• Strategic Partnership & Cross-Functional Leadership
  • 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
• Team Leadership & Talent Development
  • Lead and develop a high-performing team of actuaries and analysts
  • Establish clear priorities, governance, and quality standards for actuarial work products
  • Foster a culture of innovation, continuous improvement, and accountability
• Enterprise Contribution & Thought Leadership
  • Contribute to enterprise planning, budgeting, and long-term strategy
  • Present insights and recommendations to senior leadership in a clear, actionable manner
  • Identify opportunities for automation, analytics advancement, and process optimization

Qualifications

• Bachelor's Degree Required
• 5 years Management experience
• 7 years Actuarial experience

Benefits

• 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 development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met