1112-Director of Actuarial
About the Role
The Director of Actuarial will lead the development, implementation, and oversight of actuarial models and financial analyses to support pricing, forecasting, and risk adjustment strategies. This role will partner closely with cross-functional teams, including finance, underwriting, clinical, and analytics, to drive data-driven decisions that influence enterprise strategy and performance.
1. Financial & Actuarial Analysis
● Develop and maintain robust actuarial and financial models for premium rate setting, reserving, and forecasting.
● Analyse medical cost trends, utilisation patterns, and other key cost drivers.
● Conduct experience studies, variance analyses, and scenario modelling to support business planning.
2. CMMI / CMS Value-Based Pricing
● Design and price health insurance and value-based care products (e.g., MSSP, ACO REACH, Medicare Advantage).
● Support new product filings, ensuring compliance with CMS and CMMI requirements.
● Apply Medicare pricing methodologies and assist with regulatory submissions.
3. Risk Adjustment & Forecasting
● Support CMS risk adjustment modelling (HCC, RxHCC, CDPS, etc.) to optimise revenue accuracy.
● Forecast financial performance, revenue, and margins based on risk scores, population mix, and membership changes.
● Collaborate with analytics and finance teams to develop predictive insights for strategic planning.
4. Leadership & Collaboration
● Lead, mentor, and review the work of junior actuarial analysts and data modellers.
● Partner with cross-functional stakeholders to integrate actuarial insights into financial and operational decision-making.
● Present findings and recommendations to executive leadership, influencing strategic initiatives.
What You Need
● Bachelor’s or Master’s degree in Actuarial Science, Statistics, Mathematics, Finance, or a related field.
● FSA/ASA or equivalent actuarial credential preferred.
● 10+ years of progressive experience in actuarial, pricing, or financial analysis roles within health insurance or healthcare analytics.
● Demonstrated experience with CMS, CMMI, or Medicare programs strongly preferred.
● Technical Proficiency: SQL, SAS, R, Python, Excel (including VBA), Tableau or Power BI.
● Domain Expertise: Actuarial modeling, health insurance pricing, CMS risk adjustment, and value-based payment programs.
● Leadership Skills: Strong people management, stakeholder engagement, and executive communication capabilities.
● Analytical Strength: Exceptional ability to interpret data, model outcomes, and translate analytics into business strategies.
We offer competitive benefits to set you up for success in and outside of work.
Here’s What We Offer
● Generous Paid Time Off: Recharge and relax with 22 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performance.
● Best-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important moments.
● Recognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won’t go unnoticed.
● Comprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance.
Innovaccer Inc. is an equal opportunity employer. We celebrate diversity and are committed to fostering an inclusive workplace where all employees feel valued and empowered regardless of any characteristic protected by federal, state or local law including, without limitation, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, medical condition, disability, age, marital status, or veteran status. Innovaccer Inc. participates in the E-Verify program to confirm employment eligibility of all newly hired employees based out of the U.S. and employed by Innovaccer Inc.
For any additional information, please visit the below websites:
Disclaimer:
Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at [email protected]. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.
About Innovaccer
Innovaccer activates the flow of healthcare data, empowering providers, payers, and government organizations to deliver intelligent and connected experiences that advance health outcomes. The Healthcare Intelligence Cloud equips every stakeholder in the patient journey to turn fragmented data into proactive, coordinated actions that elevate the quality of care and drive operational performance. Leading healthcare organizations like CommonSpirit Health, Atlantic Health, and Banner Health trust Innovaccer to integrate a system of intelligence into their existing infrastructure, extending the human touch in healthcare. For more information, visit www.innovaccer.com.
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