Director, Actuarial Services

Medica•Madison, WI

5d•$150,000 - $257,200•Hybrid

About The Position

Medica is a nonprofit health plan serving over a million members across several states. We are seeking a Director, Actuarial Services to lead our actuarial department. The actuarial department's goal is to be Medica’s source of truth for product financial performance and medical trend. This role requires a commitment to producing complete, timely, and accurate actuarial analysis, and the ability to work with segments to help them meet their strategic goals and objectives. Actuaries at Medica use technical knowledge and business acumen to analyze financial experience, quantify financial risk, and project future medical expenses, adhering to the highest levels of ethics and professional standards.

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 (no visa sponsorship offered)
Legally authorized to work in the United States at the time of application

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.