Director, Actuary

Your Role

The Risk Adjustment team is accountable for developing an end-to-end strategy and managing programs to ensure coding completeness and accuracy. The Director, Actuary will report to the Vice President of Risk Adjustment. In this role you will lead the risk adjustment analytics team to inform prospective and retrospective risk adjustment programs for Medicare, ACA, and Medi-Cal. You will work cross functionally with other departments such as quality, provider network, claims, and compliance to align on goals and build efficiencies. You will also drive strategy and resource allocation through foundational analytics and reporting.

Your Knowledge and Experience

• Requires a bachelor's degree in actuarial science, mathematics, statistics, computer science or related field and 10 years prior relevant job including 3 years of management experience

• Requires ASA or FSA

• Requires working knowledge of the Medicare, ACA, and Medi-Cal risk adjustment models

• Requires experience with Medicare Advantage and/or ACA plans preferred