Director, Actuarial Services - Remote

UnitedHealth Group•Eden Prairie, MN

12h•$134,600 - $230,800•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. OptumHealth is a nationwide health care delivery organization reinventing health care to help keep everyone healthier and feeling their best. In all we do, we are committed to the quadruple aim — improving patient satisfaction, lowering costs, delivering quality outcomes and increasing provider satisfaction. Optum Care is part of a larger Optum Health care delivery network, which is at the intersection between primary care, ambulatory surgical sites and further development of specialty and ancillary networks. More than 60,000 doctors and over 2,000 primary, specialty, urgent, and surgical sites across the country work together to help people live healthier lives. The goal is to put each person on the right course of care, and we do this by providing each patient with a care team that works together to meet the patient's needs. The Director, Actuarial Services is a key role within the OptumHealth National Actuarial and Healthcare Economics (HCE) team, responsible for overseeing, executing, and communicating key actuarial functions for our Medicare Accountable Care Organizations (ACO) lines of business. This role involves managing resources and deliverables while providing customers in a risk-taking provider organization with business recommendations and contributing to the company’s financial success. This position leads a growing actuarial team responsible for assessing and quantifying risk in risk based contracts across the provider organization, and for developing strategies and designing actuarial models to support contract negotiations. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

ASA (Associate of the Society of Actuaries)
7+ years of actuarial experience with foundational literacy in healthcare analytics and modeling
3+ years of experience with any of the following: Traditional Medicare value-based arrangements, Medicare Advantage (MA) products, MA Risk Adjustment, Medicare bids, and/or VBC modeling
2+ years of experience managing actuarial analysts
Proficiency in Excel and SQL
Proven excellent problem-solving and communication skills, along with critical thinking skills to anticipate questions from key stakeholders and consider all aspects of a deliverable before completion

Nice To Haves

FSA, or progress toward FSA (Associate/Fellowship of the Society of Actuaries) designation
Experienced presenting business insights and summaries to inform decisions to stakeholders
Proven ability to self-motivate, quickly learn new business concepts and take initiatives
Experienced with Underwriting, and/or VBC modeling.

Responsibilities

Serve as the actuarial lead and primary point of contact for Medicare ACO programs (ex. MSSP, REACH / LEAD, etc.), representing the team in cross-functional discussions and providing actuarial guidance on forecasting, underwriting, performance evaluation, and strategic decision-making
Lead the development and oversight of actuarial models and forecasts to support Medicare value-based arrangements
Develop and recommend actuarially sound financial terms to effectively manage risk in risk based arrangements
Translate complex analytical findings into clear, actionable insights for operators, provider partners, finance leadership, and senior executives
Provide actuarial expertise and strategic recommendations to support program selections, contract negotiations, performance tracking, and risk management
Drive strategic initiatives, process improvements, and innovation through AI implementation, predictive modeling and creative problem solving
Partner cross-functionally to identify cost mitigation opportunities and support enterprise-wide initiatives
Oversee day-to-day execution of actuarial and analytic work in analyzing financial, claims, utilization and cost data, ensuring quality, efficiency, and alignment with business goals
Communicate effectively with technical and non-technical audiences through presentations, discussions, and written materials
Manage, mentor, and develop a team of managers and analysts, including performance management, talent development, and succession planning