Senior Director, Chief Actuary (Medicare Advantage) - Kelsey - Seybold Clinics, Houston, TX

UnitedHealth Group•Pearland, TX

1d•$159,300 - $273,200•Onsite

About The Position

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Kelsey-Seybold Managed Care Analytics exists to monitor and improve the financial performance of Kelsey-Seybold (KS) by providing actionable, data-driven insights to the organization. Within Managed Care Analytics, the Actuarial Services and Healthcare Economics teams’ primary focus is to apply actuarial science rigor to pricing, forecasting, and broader analytical exercises. The Senior Director serves as the Chief Actuary and enterprise financial leader responsible for the performance of Kelsey-Seybold’s $1B+ Medicare Advantage health plan and broader Commercial risk-bearing lines of business, impacting 200K risk lives. This role has end-to-end accountability for pricing, underwriting, revenue forecasting, claims cost projection, and margin performance, as well as leadership of the Healthcare Economics (HCE) function. This leader drives enterprise trend strategy, financial planning, and risk-based contracting, directly influencing payer negotiations, product strategy, and organizational affordability initiatives. The role partners with executive leadership optimize total cost of care, ensure actuarial and financial integrity, and deliver sustainable growth across Medicare Advantage, Exchange, and Commercial lines of business.

Requirements

BA/BS Degree in Economics, Mathematics, Actuarial Science or other related field.
Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA)
10+ years of experience in data analytics, actuarial services, underwriting, or a related field inclusive of:
8+ years of experience supervising or managing teams and/or projects
5+ years as a Healthcare Actuary
3+ years of experience with Medicare Advantage bid development
3+ years of programming experience in SQL, SAS, Python or similar programming language
Demonstrated knowledge of IBNR models
Demonstrated knowledge of actuarial cost analysis and PMPM modeling

Nice To Haves

Systems experience (i.e. enrollment/eligibility, capitation, claims payment, etc.) with an MCO
Experience with reporting tools (including Crystal Reports and Microsoft Access)
Knowledge of CMS HCC model and Risk Adjustment calculations
Familiarity with EPIC and Clarity reporting data warehouse

Responsibilities

Accountable for financial performance, forecasting, and margin outcomes across Medicare Advantage, Exchange, and Commercial lines of business
Serving as Chief Actuary for a $1B+ Medicare Advantage plan, accountable for pricing strategy, bid development, and financial performance
Owns pricing and underwriting strategy for Commercial risk contracts and capitated arrangements (120K lives, $350M revenue portfolio)
Leads and develops actuarial and healthcare economics functions, ensuring depth of expertise aligned with enterprise needs
Leads actuarial modeling and financial analysis for payer contract negotiations and value-based arrangements
Accountable for monthly close actuarial outputs, including IBNR, claims projections, and variance analysis
Owns enterprise analytics and reporting to quantify drivers of revenue, utilization, and cost trends