Senior Director, Actuarial - Risk Adjustment

Oscar Health•New York, NY

3d•$196,733 - $286,902•Remote

About The Position

Oscar is hiring a Senior Director, Actuarial – Risk Adjustment to lead its ACA risk adjustment actuarial function, including financial reporting, forecasting, and strategic analysis. The role manages a team and partners with Finance, Market P&L, Risk Adjustment Operations, Medical Economics, and Data Science to inform business strategy and financial disclosures. It translates risk adjustment performance, market dynamics, and financial implications into actionable insights for senior leadership. The position reports to the Vice President, Corporate Actuarial. This is a fully remote position for candidates residing in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories. Work is performed from a home office, with occasional travel for team meetings and company events.

Requirements

Bachelor's degree in a STEM field or four years of commensurate experience.
12 or more years of quantitative analysis experience in the healthcare industry.
Five or more years of experience collaborating with and influencing an Executive Leadership Committee.
Proven experience in a pricing role or a related analytics-driven leadership role.
Strong subject-matter expertise in government programs risk adjustment, preferably ACA Marketplace.

Nice To Haves

Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment.
Qualified, or willing to become qualified, to serve as appointed actuary for insurance companies under the American Academy of Actuaries’ Specific Qualification Standard.
Excellent communication, collaboration, and relationship-building skills.
Strong process management skills, including streamlining workflows and driving operational efficiency.
Collaborative and influential leadership style, with experience partnering across multiple teams and stakeholders.
Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements.
Fellow of the Society of Actuaries (SOA), or on the track to become one.

Responsibilities

Lead ACA risk adjustment financial reporting and forecasting, including monthly close, external audits, regulatory reviews, and other finance-related activities.
Develop strategic insights and projections regarding Oscar's ultimate risk scores and risk adjustment performance.
Analyze market morbidity drivers and their financial implications, coordinating with external stakeholders such as industry consultants.
Manage executive-facing financial forecasts and presentations, translating complex actuarial insights into strategic recommendations for senior leadership.
Build strategic partnerships across Finance, Risk Adjustment Operations, Market P&L, and other business units, and represent Actuarial in executive forums.
Direct advanced analytics initiatives and use findings to inform enterprise decisions about pricing, business growth, and network strategies.
Lead, coach, mentor, and develop actuarial professionals.
Perform other duties as assigned.