Director, Actuarial Services

Medica • Madison, WI

2d • $150,000 - $257,200 • Hybrid

About The Position

Medica is seeking a Director, Actuarial Services to lead actuarial analysis that supports product financial performance and medical trend. Actuaries analyze financial experience, quantify financial risk, and project future medical expenses while adhering to high ethical and professional standards and the standards of practice established internally and by the American Academy of Actuaries. The actuarial department aims to provide complete, timely, and accurate analysis and, at senior levels, to work with business segments to support their strategic goals and objectives. Other duties may be assigned.

This position oversees actuarial studies and reporting, risk analysis, financial targets, product pricing and forecasts, rate filings and compliance, and review of actuarial work. The role works with segment and corporate leadership, analysts, consultants, and other actuaries. It is an office role requiring onsite work an average of three days per week. Candidates may be located near Medica’s Minnetonka, Minnesota, or Madison, Wisconsin, office.

The full salary grade is $150,000–$257,200; the typical hiring range is expected to be $150,000–$225,015. Salary placement depends on factors including education, experience, certifications or licensure, role scope, internal pay equity, and market data. The position may also be eligible for incentive-plan compensation. Medica does not offer work visa sponsorship; candidates must be legally authorized to work in the United States at the time of application.

Requirements

• Bachelor’s degree or equivalent experience in a 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 of the American Academy of Actuaries (MAAA).
• Health actuarial or other related actuarial experience.

Nice To Haves

• Commercial health insurance experience, including fully insured and self-insured business.
• Experience with the Affordable Care Act (ACA).
• Experience with rate and premium setting.

Responsibilities

• Oversee the creation, development, and consistent production of accurate and timely actuarial information, reports, and exhibits.
• Review analysts’ and other credentialed actuaries’ work for reasonability, appropriateness, and relevance.
• Work with segment leadership on product design, particularly risk selection and induced utilization.
• Direct analysts or consultants in selecting key variables for sensitivity testing.
• Communicate significant variances between actual and expected financial performance to Medica and segment leadership.
• Incorporate risk adjustment into financial projections and performance analysis.
• Work with Medica and segment leadership to establish appropriate financial targets for pricing and product performance.
• Use appropriate benchmarks to analyze utilization and provider data.
• Provide actual-versus-expected analysis and intra-year targets for Medica leadership, segments, and corporate finance.
• Own the actuarial component of product pricing and work with segment leadership to incorporate actuarial, risk, and competitive information while aligning corporate and segment priorities for profit and growth.
• Ensure forecast trend, revenue, and membership projections are used appropriately by segment and corporate finance.
• Ensure rate filings and bids are accurate, submitted on time, and consistent with segment strategies and goals.
• Attend state negotiations and plenaries as necessary, and oversee preparation for rate negotiations, including analysis by rate cell and geography.
• Review low- and medium-risk actuarial work before publication.
• Sign rate-filing certifications and other actuarial communications following an appropriate level of review.
• Ensure timely and accurate monthly production of actuarial results for the segment or corporate reporting, as appropriate.
• Participate in segment activities as directed by the General Manager, including department meetings, recurring one-to-one meetings, and status reporting to segment leadership.
• Perform other duties as assigned.

Benefits

• Competitive medical, dental, and vision coverage.
• Paid time off (PTO) and holidays.
• Paid volunteer time off.
• 401(k) contributions.
• Caregiver services.
• The position may be eligible for incentive-plan compensation in addition to base salary.

What This Job Offers

• Job Type: Full-time
• Career Level: Director