Director, Actuarial Services

Medica•Madison, WI

4d•Hybrid

About The Position

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.

Requirements

Bachelor’s degree or equivalent experience in related field
10 years of experience
5 years of leadership experience
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)
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.

Nice To Haves

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

Responsibilities

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
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
Develop quarterly provider settlement estimates in partnership with Network and Finance
Deliver clear, actionable reporting on settlements by agreement type
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