Director, Actuarial
Sentara Health•Virginia Remote, VA
•Onsite
About The Position
The Director, Actuarial – Government Programs will lead actuarial pricing, financial performance insights, and strategic analytics across SHP’s Medicare and Medicaid lines of business. This role is critical to ensuring market-competitive, compliant, and financially sustainable products while translating actuarial insights into actionable business decisions. This leader will operate in a highly matrixed environment, partnering closely with Finance, Product, Network, Risk Adjustment, and Clinical teams to drive enterprise value and support SHP’s growth strategy.
Requirements
- Bachelor's Degree Required
- 5 years Management experience
- 7 years Actuarial experience
Responsibilities
- Lead end-to-end pricing for Medicare Advantage, Medicaid, and related government programs
- Develop and maintain actuarial assumptions, methodologies, and pricing models
- Ensure rate adequacy, competitiveness, and alignment with enterprise financial targets
- Oversee bid development, rate filings, and regulatory submissions
- Translate pricing assumptions into forward-looking financial projections and scenarios
- Monitor emerging experience vs. pricing assumptions and identify key drivers of variance
- Provide actionable insights to improve margin, membership growth, and cost management
- Ensure compliance with CMS, state Medicaid agencies, and insurance department requirements
- Support actuarial certifications, rate filings, and audit readiness
- Interface with regulators and external actuarial partners as needed
- Partner with Product, Network/Provider Contracting, and Clinical teams on benefit design and product strategy, value-based care and provider reimbursement models, and cost of care and utilization management strategies
- Align actuarial assumptions with operational and market realities across the enterprise
- Lead and develop a high-performing team of actuaries and analysts
- Establish clear priorities, governance, and quality standards for actuarial work products
- Foster a culture of innovation, continuous improvement, and accountability
- Contribute to enterprise planning, budgeting, and long-term strategy
- Present insights and recommendations to senior leadership in a clear, actionable manner
- Identify opportunities for automation, analytics advancement, and process optimization
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Annual discretionary bonus
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What This Job Offers
Job Type
Full-time
Career Level
Director
