Director, Actuarial

City/State Norfolk, VA Work Shift First (Days) Overview: 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

• 1. 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
• 2. 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
• 3. 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
• 4. 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 [202510-SHP...entity_EDJ | Word]
• 5. 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
• 6. 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

Candidate Requirements

• Bachelor's Degree Required.
• 5 years Management.
• 7 years Actuarial experience.
• ASA required.
• FSA preferred.

Compensation

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $210,392.00 - $308,464.00 annually. Additional compensation may be available for this role, such as shift differentials, standby/on-call pay, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually. Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick time, and holidays); paid parental and military leave; educational assistance or student loan repayment; and voluntary benefits.

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

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!