Director, Value Based Care Pricing Actuary

DOXA Insurance Holdings • Fort Wayne, IN

3d • Remote

About The Position

We are seeking an experienced actuary with deep expertise in value-based care and healthcare payer economics to serve as a key strategic partner in our Aggregate Excess of Loss business. This individual will help evaluate, price, and manage risk associated with provider organizations participating in increasingly complex value-based care arrangements. Unlike traditional health plan actuarial roles, this position offers the opportunity to help build and shape a growing business, influence underwriting strategy, and expand Chatham's presence within the rapidly evolving commercial payer market. This is a highly visible role with significant influence over portfolio growth, risk selection, carrier relationships, and long-term business strategy.

Requirements

• ASA or FSA designation (or equivalent actuarial credentials)
• 7+ years of actuarial experience within: A major health payer OR A healthcare consulting organization with significant value-based care exposure
• Deep expertise in value-based care programs and provider risk arrangements
• Strong understanding of healthcare claims analytics, risk adjustment, medical economics, and population health management
• Experience supporting Medicare Advantage, Commercial, Medicaid, ACO, MSSP, or similar risk-bearing programs
• Advanced analytical and modeling capabilities
• Intellectual curiosity
• Comfort operating in an evolving environment
• Strong business judgment
• A desire to build rather than maintain
• The ability to move quickly and make informed decisions with imperfect information

Nice To Haves

• Experience pricing or evaluating provider risk contracts
• Exposure to stop loss, reinsurance, or risk-transfer products
• Experience working directly with provider organizations, health systems, physician groups, or managed care organizations
• Consulting experience supporting payer and provider clients
• Experience communicating complex actuarial concepts to business leaders and executives

Responsibilities

• Partner directly with underwriting leadership to evaluate and price Aggregate Excess of Loss opportunities
• Assess provider risk arrangements involving Medicare Advantage, Commercial, Medicaid, and other value-based care programs
• Analyze healthcare claims experience, provider performance, and financial risk-sharing structures
• Develop actuarial models and pricing methodologies to support underwriting decisions
• Identify and evaluate emerging opportunities within value-based care markets
• Provide insight into payer-provider relationships, reimbursement structures, risk adjustment, and performance incentives
• Help establish underwriting guidelines and risk selection frameworks for new market opportunities
• Support portfolio management efforts by monitoring trends, profitability, and volatility across the book of business
• Serve as a trusted subject matter expert with carrier partners and internal stakeholders
• Collaborate with leadership on strategic growth initiatives and market expansion opportunities

Benefits

• Flexible remote work environment
• Competitive compensation (based on experience)
• Comprehensive benefits package: Medical, dental, vision, Life & long-term disability insurance, 401(k) with company match, Generous PTO and sick time
• Career advancement within a growing specialty insurance platform
• Phantom equity participation aligned to business performance

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed