Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Senior Director, Actuarial Science (Healthcare Policy - Medicaid, Medicare, Marketplace)

$135.6k - $237.4k
Full-time

CareSource

Job Summary:

The Senior Director, Actuarial Science is responsible for setting the strategic direction, driving innovation and producing key insights for the organization that drive company performance.

Essential Functions:
  • Provides strategic thought leadership on healthcare policy, maintaining expertise in Medicaid, Medicare, Marketplace, and evolving legislative and regulatory requirements; assesses emerging trends and translates their potential impact into actionable organizational strategies.
  • Accountable for pricing, forecasting, month-end close activities and performance monitoring and explanations; includes development of key processes and assumptions, accruals and evaluation of financial experience and trend drivers including comparisons to budget and reforecast. Develop activities to improve efficiency and affordability.
  • Lead a team of actuaries ensuring compliance with applicable Actuarial Standards of Practice and supporting their training and personal development.
  • Develop the strategy and guide teams in the development of multiple internal statistical models to support key business goals / initiatives; bid pricing models, financial projections, contract modeling, ad hoc support projects.
  • Ensure internal stakeholders are held accountable for actuarial function requests supporting key assumptions to be used throughout Finance and the broader organization.
  • Proactively identify and influence at Senior Management levels Actuarial concepts / business drivers to support interactions with federal level and state level regulators.
  • On request, lead new business projects for the business development team at the Senior Management level.
  • Accountable for the integrity of all federal or state rate filing requirements as necessary.
  • Identify and lead opportunities across multiple functions within the organization where the actuarial team can drive completion of corporate goals.
  • Oversee effectiveness of mentorship programs for analysts.
  • Remain current, be able to explain and understand business impacts of all pertinent industry developments, including but not limited to, federal and state regulations and sub-regulatory guidance.
  • Recommends and operationalizes strategies that have direct impact on the achievement of functional strategies.
  • Understand and explain the financial drivers for owned product/market, including IBNR and other accruals.
  • Engage with federal and state trade associations, regulators, and other external stakeholders on policy and legislative matters, providing actuarial perspective to inform advocacy, regulatory interpretation, and business positioning
  • Provide actuarial expertise to internal business, government affairs, compliance, legal, and other teams on proposed policy, legislation, regulations, and sub-regulatory guidance; support the development of organizational feedback, comments, and other responses that reflect financial, operational, and actuarial considerations
  • Perform any other job related duties as requested.


Education and Experience:

  • Bachelor's degree in actuarial science, mathematics, economics or a related field required
  • Ten (10) years of decision support, financial analysis, or actuarial experience preferred
  • Five (5) years of management experience preferred
  • Strong database (SAS or Access) experience preferred
  • Managed Care or healthcare experience preferred

Competencies, Knowledge and Skills:

  • Excellent written and verbal communication skills
  • Excellent listening and critical thinking skills
  • Strong interpersonal skills and high level of professionalism
  • Ability to manage, develop, and motivate staff
  • Ability to interact with all levels of management as well as external stakeholders
  • Excellent problem-solving skills and attention to detail
  • Ability to effectively report data, analyze facts, and exercise sound business judgment when making recommendations
  • Ability to identify and analyze problems, draw conclusions, develop and lead processes and communicate status and results
  • Expert proficiency with Microsoft Suite to include Excel, Word, Power Point and Outlook
  • Advanced knowledge of SQL, SAS, R, or other data manipulation software is preferred

Licensure and Certification:

  • Associate of the Society of Actuaries (ASA) required
  • Fellow of the Society of Actuaries (FSA) preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • Up to 15% (occasional) travel based on the needs of the department may be required

Compensation Range:

$135,600.00 - $237,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-RW1Brand=CareSource
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Senior Director, Actuarial Science (Healthcare Policy - Medicaid, Medicare, Marketplace) in Remote vacancy
  • $135.6k - $237.4k

     ...steps. Our partner is looking for a Senior Director, Actuarial Science based in the United States. This...  ...functions. You will help navigate evolving healthcare regulations and engage with...  ...and external stakeholders on critical policy matters. This role offers significant... 
    Actuarial
    Senior
    Policy
    Full time
    Contract work
    Remote work

    jobgether

    United States
    4 days ago
  • $130.8k - $206.5k

     ...needs to deliver the healthcare we all deserve. We are...  ...strategic legal advisor to senior leadership and...  ...legal support across Medicare Part D, healthcare regulatory...  ...Law Medicare and Medicaid requirements...  ...compliance investigations, policy development, training... 
    Senior
    Policy
    Full time
    Contract work
    Local area
    Remote work
    Flexible hours
    3 days per week

    Judi Health

    New York, NY
    1 day ago
  •  ...Health Analytics Practice Group is seeking a Senior Consulting Actuary to apply actuarial expertise to Medicaid policy, financing, and program evaluation. You will conduct...  ...governments, public-sector agencies, and healthcare clients. This role offers flexible locations (... 
    Actuarial
    Senior
    Policy
    Remote job
    Flexible hours

    BerryDunn

    Brooklyn, NY
    1 day ago
  • $126.3k - $210.5k

    Senior Advisor, Medicaid & Marketplace StrategyWe are looking for a strategic, client-focused leader who is passionate...  ...You will bring clarity to complex policy and market dynamics while shaping...  ...’s degree in business, healthcare administration, public policy, pharmacy... 
    Senior
    Policy
    Full time
    Local area
    Work from home

    CIGNA

    Bloomington, MN
    15 hours ago
  •  ...innovation stalls. As a Senior Health Economist at...  ...health plan C-suite, actuarial teams) with polished,...  ...(commercial, Medicare, Medicaid), including deep knowledge...  ...automate the delivery of healthcare - starting with...  ...and candidate privacy policy.Beware of Phishing Attempts... 
    Actuarial
    Senior
    Policy
    Work at office
    Local area
    Remote work
    Worldwide
    3 days per week

    Hinge Health

    San Francisco, CA
    4 days ago
  • $200k - $275k

     ...makers in state government healthcare agencies, mission-...  ...together deep expertise in actuarial science, health economics, data science, policy analysis, healthcare...  ...strategic decisions. As a Senior Consulting Actuary, you...  ...challenges facing Medicaid programs, public-sector... 
    Actuarial
    Senior
    Policy
    Work at office
    Remote work

    BerryDunn

    Brooklyn, NY
    1 day ago
  • $250k

     ...ever-innovating marketplace focused on our singular...  ...of food, healthcare, and outcomes-driven...  ...growth areas, and the Medicaid segment...  ...2B and will be a senior, foundational hire...  ...Medicaid, Medicaid policy, and selling to organizations...  ..., Medicaid Directors, and other key... 
    Senior
    Policy
    Full time
    Contract work
    Local area

    CookUnity

    Remote
    2 days ago
  • $210.9k - $379.2k

     ...drive intellectual property policies internally and externally to...  ...communicate effectively with senior business leaders, as well as...  ...everywhere in between.Best-in-class healthcare coverage, plus voluntary...  ...to have been recognized as a Science Magazine Top Biopharma Employer... 
    Senior
    Policy
    Permanent employment
    Full time
    Work at office
    Work from home

    Moderna Therapeutics

    Cambridge, MA
    1 day ago
  • $210.9k - $379.2k

     ...is seeking a Global Medical Director to lead medical affairs strategy...  ...and influence health policy.Developing and executing publication...  ...ability to translate complex science into clear, impactful...  ...everywhere in between.Competitive healthcare, plus voluntary benefit programs... 
    Senior
    Policy
    Permanent employment
    Full time
    Work at office
    Work from home
    Worldwide

    Moderna Therapeutics

    Cambridge, MA
    3 days ago
  • $185k - $200k

     ...with the expertise of some 800 policy advocates, lawyers,...  ...challenges, and advance innovative, science-based, and enforceable solutions...  ..., as well as through the marketplace. Our team works across the United...  ...globally, and to serve as a senior external representative for... 
    Senior
    Policy
    For subcontractor
    Work at office
    Local area
    Flexible hours
    Night shift

    Natural Resources Defense Council

    Chicago, IL
    1 day ago
  • $78.8k - $145.13k

    Milliman’s Medicaid Finance and Policy Practice is seeking individuals to assist...  ...financial reporting support for healthcare finance and payment rate...  ...work closely with CPAs, actuaries, and policy experts on...  ...available data including Medicare cost reports, fee schedules... 
    Actuarial
    Policy
    Full time
    Temporary work
    Work experience placement
    Work at office
    Remote work
    Worldwide
    Flexible hours

    Milliman

    Chicago, IL
    15 hours ago
  • $164.78k - $314.96k

     ...consistent with applicable policy and business needs...  ...Analytics Director to lead our...  ...area of decision science support. Oversees...  ...Statistics, Mathematics, Actuarial Sciences, Operations...  ...leadership up to senior executive levels....  ...data co-ops, data marketplaces, credit bureaus) to... 
    Actuarial
    Policy
    Full time
    H1b
    Work at office
    Remote work
    Relocation package

    USAA

    San Antonio, TX
    1 day ago
  • $196.7k - $353.4k

     ...The RoleModerna is seeking a Senior Director, Executive Compensation to...  ...executive compensation programs, policies, processes, and governance...  ...in between.Competitive healthcare, plus voluntary benefit programs...  ...have been recognized as a Science Magazine Top Biopharma Employer... 
    Senior
    Policy
    Full time
    Work at office
    Work from home

    Moderna Therapeutics

    Cambridge, MA
    15 hours ago
  • $124.8k - $171.6k

     ...looking for a hands-on Senior Product Manager to...  ...or M.S. in Computer Science, Engineering, or a related...  ...in healthcare, insurance, or another...  ...life for people with Medicare and Medicaid, families, individuals...  ...Opportunity EmployerIt is the policy of Humana not to discriminate... 
    Senior
    Policy
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Relocation
    Shift work
    3 days per week

    Humana

    Louisville, KY
    1 day ago
  •  ...clients turn data into action as a Sr. Healthcare Data Analyst at GDIT. Your work will...  ...of our team to support the Centers for Medicare & Medicaid Services (CMS) mission to detect and prevent...  ...the Medicaid program integrating policy understanding and in-depth claims... 
    Senior
    Policy

    General Dynamics Information Technology

    Remote
    16 days ago
  • $155k - $200k

     ...restore their lives.The Senior Manager / Associate Director, Cost Accounting will lead...  ...maintain cost accounting policies, procedures, and internal...  ...driven by a passion for science and compassion for patients...  ..., our patients and their healthcare providers.Notice to... 
    Senior
    Policy
    Full time
    Local area
    Remote work

    Orca Bio

    Menlo Park, CA
    1 day ago
  • $45 - $50 per hour

    Role Description The Senior Healthcare Informatics Analyst position...  ...Pharmacy, Clinical, Actuarial, Finance, and IT...  ...Analytics, Computer Science, or a related field required...  ...of commercial and Medicare Advantage pharmacy...  ...business rules and policies into analytical models... 
    Actuarial
    Senior
    Policy
    Contract work
    Work at office

    S3

    Remote
    15 hours ago
  • $200k - $300k

     ...We are redefining healthcare delivery to make...  ...Summary The Senior Director, Reimbursement –...  ...access, and health policy strategy across Baxter...  ..., including Medicare (CMS), TRICARE, and federal marketplace programs as applicable...  ...·         Direct Medicaid strategy across... 
    Senior
    Policy
    Temporary work
    Local area
    Flexible hours

    Baxter International Inc

    Saint Paul, MN
    12 days ago
  • $1,020 per month

     ...INITIATIVE SENIOR DIRECTOR, HEALTH PLANS...  ...income. Yet our healthcare system is built...  ...redesign their policies and invest preventatively...  ...to use Medicaid dollars to provide...  ...plans with Medicare, Medicaid, Marketplace, and/or commercial...  ..., product, actuarial, analytic, communications... 
    Actuarial
    Senior
    Policy
    Full time
    Temporary work
    Interim role
    Work at office
    Remote work
    Flexible hours
    Shift work
    Weekend work
    Afternoon shift

    Positively Partners

    Attleboro, MA
    more than 2 months ago
  • $203.78k - $339.63k

     ...patients. The role of Director, Global Real-...  ...into the Senior Director, Global...  ...accordance with GSK policies.Basic QualificationsWe...  ...health or life sciences.3+ years’...  ...and complexity of healthcare markets, health...  ...the Centers for Medicare and Medicaid Services (CMS) website... 
    Policy
    Full time
    Local area
    Work from home
    Flexible hours

    GSK

    Pennsylvania
    15 hours ago
  •  ...webpage. Functional Title: CFO Actuarial Analysis Project Manager Job...  ...IV performs advanced, senior-level project management work...  ...project management support for Medicaid managed care capitation calculations...  ..., evaluating, and modifying policy as needed; coordinating with... 
    Actuarial
    Senior
    Policy
    Full time
    Contract work
    Temporary work
    Part time
    Work at office
    Remote work
    Shift work

    Texas Health and Human Services Commission

    Austin, TX
    1 day ago
  • $124k - $211k

     ...Posting Title Lead Actuary - Pharmacy...  ...partners closely with senior leaders to...  ...Monitor health policy, regulatory, and...  ...Math, Actuarial Science, Economics or Finance...  ...6 years in a healthcare organization or...  ...pricing Commercial, Medicare, and/or Medicaid pharmacy... 
    Actuarial
    Policy
    Work experience placement
    Local area
    Remote work
    Visa sponsorship
    Work visa

    Prime Therapeutics

    United States
    1 day ago
  • $149k - $279k

     ...about delivering extraordinary care.Senior Technical Director - Nationwide Financial Actuarial - RemoteActuarial Technology...  ...product mechanics and embedded policy owner options, valuation and non...  ...Undergraduate degree in actuarial science, mathematics, statistics or... 
    Actuarial
    Senior
    Policy
    Full time
    Temporary work
    Part time
    Casual work
    Work at office
    Remote work

    Nationwide

    Columbus, OH
    15 hours ago
  • $78k - $124.8k

     ...communications, data analytics, underwriting, actuarial, etc. teams in the review of plan...  ..., Imputed Income, Statutory Disability, Medicare Part D Creditable Coverage and Minimum Value...  ...and service agreements (i.e. Policies, Certificates, Adoption Agreements, Summary... 
    Actuarial
    Senior
    Policy
    Full time
    Work at office
    Flexible hours

    Stephens

    Little Rock, AR
    4 days ago
  • $104k - $143k

     ...also partner with actuarial, corporate finance...  ...with providers and senior leadership.Analyze...  ...3 or more years healthcare economics or value...  ...experienceExperience in the Medicare Advantage bid...  ...with Medicare and Medicaid, families,...  ...EmployerIt is the policy of Humana not to discriminate... 
    Actuarial
    Policy
    Bi-weekly pay
    Full time
    Contract work
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office

    Humana

    Fort Lauderdale, FL
    1 day ago
  •  ...Senior Benefits Manager Primary Location: Parsippany Location: Parsippany, NJ, US, 07...  ...dental, and prescription drug plans. Actuarial Modeling: Partner with consultants and actuaries...  ...Employment Opportunity It is Sun's policy that applicants for employment are... 
    Actuarial
    Senior
    Policy
    Temporary work
    Remote work

    Sun Chemical

    Parsippany, NJ
    2 days ago
  • $112.7k - $170k

     ...an Associate Director of Actuarial Services , you...  ...in actuarial science, a technical skillset...  ...including senior leadersServe...  ...leadership with Medicare Advantage, Commercial, and Medicaid risk...  ...transforming large healthcare claims datasets...  ...Telecommuter Policy.Pay is based on... 
    Actuarial
    Policy
    Minimum wage
    Full time
    Contract work
    Work experience placement
    Local area
    Remote work

    UnitedHealth Group

    Eden Prairie, MN
    4 days ago
  • $92.7k - $113.3k

     ...world.   We are Herrera, a science, planning, and design...  ...future), and partnering with the Director of People & Culture to advance...  ...develop clear and compelling policies, leadership recommendations,...  ...25 flexible benefits plans – healthcare and dependent care ~ Company... 
    Senior
    Policy
    Full time
    Temporary work
    For contractors
    Work at office
    Local area
    Remote work
    Flexible hours
    Shift work

    Herrera Environmental Consultants, Inc.

    Seattle, WA
    16 days ago
  •  ...advance in your career. Unlimited PTO Enjoy greater flexibility and work-life balance with Click Therapeutics unlimited PTO policy! Our unlimited PTO policy allows employees to take the time they need for rest, relaxation and attending to personal matters without... 
    Senior
    Policy
    Full time

    Click Therapeutics, Inc.

    New York, NY
    1 day ago
  • $125k - $155k

     ...improve government healthcare programs that are lifelines...  ...the intersection of policy, data, and user...  ...Role As an A1M Senior UX Researcher, you...  ...Working knowledge of Medicare, the ACA, MACRA, Medicaid, or CHIP Familiarity...  ..., Information Science, Graphic Design, or... 
    Senior
    Policy
    Permanent employment
    Full time
    Contract work
    Temporary work
    For contractors
    For subcontractor
    Work at office
    Local area
    Remote work

    A1M Solutions

    Remote
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Senior Director, Actuarial Science (Healthcare Policy - Medicaid, Medicare, Marketplace). Be the first to apply!