Remote Senior Director, Actuarial - Risk Adjustment

Oscar-Health-; United States; Remote; USD 197,000 - 258,000; Full time

Benefits offered by this job

Unlimited vacation

Equity grants

Annual performance bonuses

Job summary

Oscar Health is hiring a Senior Director, Actuarial - Risk Adjustment to lead ACA risk adjustment, forecasting, and financial reporting. This remote role reports to the Vice President of Corporate Actuarial and collaborates with Finance, Market P&L, Operations, Medical Economics, and Data Science to provide actionable insights for senior leadership.

The position requires extensive actuarial experience and leadership, with travel for team meetings and events.

Qualifications

• Bachelor's degree in STEM or 4+ years of commensurate healthcare analytics experience.
• 12+ years of quantitative analysis in healthcare.
• 5+ years collaborating with an Executive Leadership Committee.
• Experience in pricing or analytics-driven leadership roles.
• Strong risk adjustment subject matter expertise, ACA-focused preferred.
• Experience leading actuarial financial reporting, including claims reserving and risk adjustment.
• Qualified or willing to become qualified as appointed actuary per SOA standards.
• Excellent communication and relationship-building skills.
• Strong process management and cross-team collaboration.
• Knowledge of ACA healthcare laws and regulations.
• SOA fellowship or progress toward it.

Responsibilities

• Lead ACA risk adjustment financial reporting and forecasting, including monthly close and regulatory reviews.
• Develop insights and projections on risk scores and risk adjustment performance.
• Analyze market morbidity drivers and their financial implications with external stakeholders.
• Lead executive-facing reporting and translate actuarial insights into strategic recommendations.
• Build partnerships across Finance, Risk Adjustment Operations and Market P&L.
• Direct advanced analytics to inform pricing, growth and network strategies.
• Lead and develop the actuarial team with coaching and mentoring.
• Perform other duties as assigned.

Skills

Actuarial leadership

Financial forecasting

Executive communication

Cross-functional collaboration

Risk adjustment analysis

Education

Bachelor's degree in STEM

SOA fellowship or in progress

Job description

Oscar Health is hiring a Senior Director, Actuarial - Risk Adjustment to lead ACA risk adjustment, forecasting, and financial reporting. This remote role reports to the Vice President of Corporate Actuarial and collaborates with Finance, Market P&L, Operations, Medical Economics, and Data Science to provide actionable insights for senior leadership.

The position requires extensive actuarial experience and leadership, with travel for team meetings and events.