Director, Actuarial Services - Remote

RXinsider LTD.; Eden Prairie, Northern (MN, KY); Hybrid; USD 135,000 - 231,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Telecommuter policy

Job summary

UnitedHealth Group is seeking an experienced Director of Actuarial Services to oversee Medicare ACO actuarial functions. You will lead a growing team, develop risk models, and provide strategic guidance for contract negotiations and performance evaluation.

Remote work is supported from anywhere in the U.S.; in the Minneapolis area some in-office presence may be required. This position emphasizes leadership, analytics, and cross-functional collaboration with senior executives.

Qualifications

• ASA designation required for consideration.
• 7+ years actuarial experience with healthcare analytics and modeling.
• 3+ years in Medicare value-based arrangements or related modeling.
• 2+ years of managing actuarial analysts.
• Proficient in Excel and SQL.
• Strong problem solving and communication skills.

Responsibilities

• Actuarial lead and primary contact for Medicare ACO programs.
• Develop and oversee actuarial models and forecasts.
• Propose actuarially sound financial terms for risk-based contracts.
• Translate complex findings into actionable insights for leadership.
• Provide strategic recommendations for program selections and negotiations.
• Drive AI, predictive modeling, and process improvements.
• Mentor and develop managers and analysts.

Skills

ASA designation

Actuarial experience

Healthcare analytics

Medicare modeling

Excel

SQL

Analytical thinking

Communication

People management

Education

ASA designation

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Caring. Connecting. Growing together.

OptumHealth is a nationwide health care delivery organization reinventing health care to help keep everyone healthier and feeling their best. In all we do, we are committed to the quadruple aim - improving patient satisfaction, lowering costs, delivering quality outcomes and increasing provider satisfaction. Optum Care is part of a larger Optum Health care delivery network, which is at the intersection between primary care, ambulatory surgical sites and further development of specialty and ancillary networks. More than 60,000 doctors and over 2,000 primary, specialty, urgent, and surgical sites across the country work together to help people live healthier lives. The goal is to put each person on the right course of care, and we do this by providing each patient with a care team that works together to meet the patient's needs.

The Director, Actuarial Services is a key role within the OptumHealth National Actuarial and Healthcare Economics (HCE) team, responsible for overseeing, executing, and communicating key actuarial functions for our Medicare Accountable Care Organizations (ACO) lines of business. This role involves managing resources and deliverables while providing customers in a risk-taking provider organization with business recommendations and contributing to the company's financial success.

This position leads a growing actuarial team responsible for assessing and quantifying risk in risk based contracts across the provider organization, and for developing strategies and designing actuarial models to support contract negotiations.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities

• Serve as the actuarial lead and primary point of contact for Medicare ACO programs (ex. MSSP, REACH / LEAD, etc.), representing the team in cross-functional discussions and providing actuarial guidance on forecasting, underwriting, performance evaluation, and strategic decision-making
• Lead the development and oversight of actuarial models and forecasts to support Medicare value-based arrangements
• Develop and recommend actuarially sound financial terms to effectively manage risk in risk based arrangements
• Translate complex analytical findings into clear, actionable insights for operators, provider partners, finance leadership, and senior executives
• Provide actuarial expertise and strategic recommendations to support program selections, contract negotiations, performance tracking, and risk management
• Drive strategic initiatives, process improvements, and innovation through AI implementation, predictive modeling and creative problem solving
• Partner cross-functionally to identify cost mitigation opportunities and support enterprise-wide initiatives
• Oversee day-to-day execution of actuarial and analytic work in analyzing financial, claims, utilization and cost data, ensuring quality, efficiency, and alignment with business goals
• Communicate effectively with technical and non-technical audiences through presentations, discussions, and written materials
• Manage, mentor, and develop a team of managers and analysts, including performance management, talent development, and succession planning

All While Working In An Environment That Allows

• Effective project & time management; Flexibility in your work schedule
• Participation in team problem solving; Contribution to team effectiveness
• Inclusion into the UHG Actuarial Study Program, including company sponsored study hours and study materials

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• ASA (Associate of the Society of Actuaries)
• 7+ years of actuarial experience with foundational literacy in healthcare analytics and modeling
• 3+ years of experience with any of the following: Traditional Medicare value-based arrangements, Medicare Advantage (MA) products, MA Risk Adjustment, Medicare bids, and/or VBC modeling
• 2+ years of experience managing actuarial analysts
• Proficiency in Excel and SQL
• Proven excellent problem-solving and communication skills, along with critical thinking skills to anticipate questions from key stakeholders and consider all aspects of a deliverable before completion

Preferred Qualifications

• FSA, or progress toward FSA (Associate/Fellowship of the Society of Actuaries) designation
• Experienced presenting business insights and summaries to inform decisions to stakeholders
• Proven ability to self-motivate, quickly learn new business concepts and take initiatives
• Experienced with Underwriting, and/or VBC modeling.
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income‑deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.