Senior Director, Actuarial - Risk Adjustment

The role

The Senior Director, Actuarial - Risk Adjustment leads the ACA risk adjustment actuarial function. This person manages a team and partners across various departments to inform business strategy and financial disclosures.

What you will do

• Lead financial reporting and forecasting for ACA risk adjustment.
• Develop strategic insights and projections regarding risk scores and performance.
• Analyze market morbidity drivers and financial implications.
• Lead executive-facing reporting and deliver presentations to senior leadership.
• Build strategic partnerships across key business units.
• Direct advanced analytics initiatives to shape enterprise-wide decision-making.
• Lead and develop a team of actuarial professionals.
• Other duties as assigned.

Required qualifications

• Bachelor's degree in a STEM field, or 4 years commensurate experience.
• 12+ years of quantitative analysis in the healthcare industry.
• 5+ years of collaborating and influencing an Executive Leadership Committee.
• Proven experience in a pricing role, or a related analytics-driven leadership role.
• Strong government programs risk adjustment subject matter expertise, preferably in ACA Marketplace.

Nice to have

• Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment.
• Qualified (or willing to become qualified) to serve as appointed actuary for insurance companies the American Academy of Actuaries’ Specific qualification standard.
• Excellent communication, collaboration, and relationship-building skills.
• Strong process management skills, with experience streamlining workflows and driving operational efficiency.
• Collaborative and influential leadership style, with experience partnering across multiple teams and stakeholders.
• Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements.
• Fellow of the Society of Actuaries (SOA), or on the track to become one.

Benefits

• Unlimited vacation program
• Company equity grants
• Annual performance bonuses
• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements

About the company

Oscar is a health insurance company built around a full stack technology platform. It was started in 2012 to create a health insurance company that behaves like a doctor in the family.