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Director, Actuarial Services

$150k - $257.2k
Full-time

Medica

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We’re a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration—because success is a team sport. It’s our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Actuaries use technical knowledge and business acumen to analyze financial experience, quantify financial risk, and project future medical expenses. They are expected to adhere to the highest levels of ethics, professionalism, and standards of practice, as defined both internally and by the American Academy of Actuaries. The goal of the actuarial department is to be Medica’s source of truth for product financial performance and medical trend. At all levels, this requires a commitment to producing complete, timely, and accurate actuarial analysis. For more senior positions, this also requires the ability and willingness to work with the segments and help them meet their strategic goals and objectives. Key Accountabilities

  • Reserving
  • Design and maintain a consolidated reserving model and process across books
of business
  • Develop and monitor monthly fee-for-service claims projections
  • Produce monthly variance reporting against budget and forecast, including
key drivers * Support the preparation of annual statement actuarial opinions and memoranda
  • Provide actuarial support for financial audits
  • Data Analytics
  • Maintain a strong working knowledge of actuarial data and available
technology tools * Oversee the development and production of accurate, timely actuarial reports and exhibits * Review analyst and actuarial work for reasonability, appropriateness, and relevance
  • Provider Settlement
  • Develop quarterly provider settlement estimates in partnership with Network
and Finance
  • Deliver clear, actionable reporting on settlements by agreement type
  • Direct and Mentor Actuarial Staff
  • Provide oversight and review of low- and medium-risk actuarial work prior
to release
  • Sign actuarial communications after appropriate level of review
  • Maintain accountability for timely, high-quality deliverables
  • Engage in segment activities, including department meetings, recurring
1:1s, and communication of status to leadership Required Qualifications
  • Bachelor’s degree or equivalent experience in related field
  • 10 years of experience and 5 years of leadership experience
Required Certifications/Licensure
  • Fellowship in the Society of Actuaries (FSA)
  • ASA with demonstrated performance over multiple years under the supervision
of a qualified actuary * Member, American Academy of Actuaries (MAAA) Preferred Qualifications * Health insurance actuarial experience with familiarity across multiple products * Deep expertise in reserving methodologies and processes, including IBNR development, variance analysis, and reserve adequacy assessments * Experience supporting statutory reporting, actuarial opinions, and financial audits * Strong understanding of drivers of medical cost trends and financial performance This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI. The full salary grade for this position is $150,000– $257,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $150,000– $225,015. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Vacancy posted 3 days ago
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