Senior Director, Actuarial - Risk Adjustment

Oscar-Health-; United States; Remote; USD 197.000 - 258.000; Vollzeit

Benefits dieser Stelle

Unlimited vacation

Equity grants

Annual performance bonuses

Zusammenfassung

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.

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Actuarial leadership

Financial forecasting

Executive communication

Cross-functional collaboration

Risk adjustment analysis

Ausbildung

Bachelor's degree in STEM

SOA fellowship or in progress

Jobbeschreibung

Remote

Hi, we're Oscar. We're hiring a Senior Director, Actuarial - Risk Adjustment to join our Actuarial team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves- one that behaves like a doctor in the family.

About the role:

The Senior Director, Actuarial - Risk Adjustment leads Oscar's ACA risk adjustment actuarial function, with responsibility for financial reporting, forecasting, and strategic analysis. You manage a team and partners across Finance, Market P&L, Risk Adjustment Operations, Medical Economics, and Data Science to inform business strategy and financial disclosures. You will translate risk adjustment performance, market dynamics, and financial implications into clear, actionable insights for senior leadership.

You will report to the Vice President, Corporate Actuarial.

Work Location:

This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $218,592 - $286,902 per year. The base pay for this role in all other locations is: $196,733 - $258,212 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• ACA Risk Adjustment Financial Reporting & Forecasting: Lead financial reporting and forecasting for ACA risk adjustment, including monthly close, external audits, regulatory reviews, and other finance-related activities.
• Oscar Risk Score Analysis & Projection: Develop strategic insights and projections regarding Oscar's ultimate risk scores and risk adjustment performance.
• Market Morbidity Analysis & Projection: Analyze market morbidity drivers and their financial implications, coordinating with key external stakeholders including industry consultants.
• Executive Advising & Reporting: Lead executive-facing reporting by managing key financial forecasts and delivering presentations that translate complex actuarial insights into actionable strategic recommendations for senior leadership.
• Cross-Functional Leadership: Build strategic partnerships across key business units (e.g., Finance, Risk Adjustment Operations, Market P&L) and represent the Actuarial function in executive forums.
• Advanced Analytics & Growth: Direct advanced analytics initiatives, leveraging key findings to shape enterprise-wide decision-making regarding pricing, strategic business growth, and network strategies.
• Team Management & Development: Lead and develop a team of actuarial professionals, providing coaching, mentorship and professional development to foster continuous growth across the Actuarial team.
• Other duties as assigned.

Requirements:

• Bachelor's degree in a STEM field, or 4 years commensurate experience.
• 12+ years of quantitative analysis in the healthcare industry.
• 5+ years of collaborating and influencing an Executive Leadership Committee.
• Proven experience in a pricing role, or a related analytics-driven leadership role.
• Strong government programs risk adjustment subject matter expertise, preferably in ACA Marketplace.
• 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 the American Academy of Actuaries' Specific qualification standard.
• Excellent communication, collaboration, and relationship-building skills.
• Strong process management skills, with experience 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.

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI):

Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([e-mail]) to make the need for an accommodation known.

California Residents:

For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Oscar Health's Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

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