Director, Actuarial

Sentara Health; Norfolk (VA); On-site; USD 160,000 - 230,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

401k/403B with Employer Match

Paid Time Off and Sick Leave

Parental & Family Caregiver Leave

Discretionary bonus opportunity

Job summary

Sentara Health in Norfolk, VA seeks a Director, Actuarial – Government Programs to lead pricing, financial performance insights, and strategic analytics across Medicare and Medicaid lines. You will oversee end-to-end pricing, model development, and regulatory submissions while guiding cross-functional teams to improve margins and member growth.

Requires ASA with 7+ years actuarial experience, 5+ years management, and a Bachelor’s degree. FSA is preferred.

Qualifications

• Bachelor’s Degree is required.
• Minimum 5 years management experience.
• Minimum 7 years actuarial experience.
• ASA certification required.
• FSA certification preferred.

Responsibilities

• Lead Government Programs Pricing & Financial Management for Medicare Advantage, Medicaid and related government programs.
• Oversee end-to-end pricing, bid development, rate filings, and regulatory submissions.
• Develop and maintain actuarial assumptions, methodologies, and pricing models.
• Translate pricing assumptions into forward-looking financial projections and scenarios.
• Ensure rate adequacy, competitiveness, and alignment with enterprise financial targets.
• Provide actionable insights to improve margin, membership growth, and cost management.
• Interface with regulators and external actuarial partners as needed.
• Lead and develop a high-performing team of actuaries and analysts.

Education

Bachelor’s Degree

Job description

Overview
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.

City/State
Norfolk, VA

Work Shift
First (Days)

Core Responsibilities

• Government Programs Pricing & Financial Management
• 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
• Forecasting & Performance Insights
• 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
• Regulatory & Compliance Leadership
• 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
• Strategic Partnership & Cross‑Functional Leadership
  • Benefit design and product strategy
  • Value‑based care and provider reimbursement models
  • Cost of care and utilization management strategies
• Align actuarial assumptions with operational and market realities across the enterprise
• Team Leadership & Talent Development
  • 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
• Enterprise Contribution & Thought Leadership
  • 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

Qualifications

• Bachelor’s Degree Required
• 5 years Management Experience
• 7 years Actuarial Experience
• ASA Required
• FSA Preferred

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 opportunity when system and employee eligibility criteria are met

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its workforce, guiding principle to reflect the communities it serves. In support of our mission “to improve health every day,” this is a tobacco‑free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

• Alabama
• Delaware
• Florida
• Georgia
• Idaho
• Indiana
• Kansas
• Louisiana
• Maine
• Maryland
• Minnesota
• Nebraska
• Nevada
• New Hampshire
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Pennsylvania
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Virginia
• Washington
• West Virginia
• Wisconsin
• Wyoming