Position: Director, Actuarial Services
The Director of Actuarial Services is a dynamic role providing strategic leadership and deep expertise in actuarial modeling of VBC programs in a fast-paced environment. Reporting to the AVP of Actuarial Services, this role partners closely with key stakeholders across Medical Economics, Clinical, and Client Partnership functions to identify data-driven opportunities. In addition, collaborates with Legal and Business Development teams to structure and evaluate Value-Based economics for contracts. They will have a strong skillset in managing forecast assumptions, interpreting financial results, and delivering enterprise reporting to executive audiences.
Responsibilities
Apply actuarial principles to analyze healthcare claims and utilization data, including trend and seasonality adjustments, in support of optimizing and reconciling VBC contracts
Develop, maintain, and analyze projection models
Lead the forecasting process, including assumption refreshes, run control, and sensitivity/scenario analyses
Develop and incorporate ADT-based claims projections into forecasting and reporting processes, in partnership with Medical Economics leadership
Own central actuarial reporting deliverables for executive audiences, including clear narratives, variance drivers, and strategic implications
Lead reinsurance analytics and reporting, including treaty terms interpretation, ceded claims estimation, and reconciliation of expected vs. actual results
Establish, document, and maintain actuarial standards, procedures, and controls
Position Requirements
Bachelor’s degree in actuarial science, mathematics, or related field, with an Associate of the Society of Actuaries
Minimum of eight (8) years of healthcare actuarial experience, including experience with value-based healthcare economics and different value-based care arrangements.
Proficiency in MS Excel for building actuarial models and summarized revenue and claims reports
Fellow of the Society of Actuaries preferred
Medicare Advantage Part C bid pricing experience is a plus
Experience developing healthcare seasonality factors is preferred
ADT-based projection experience is preferred
Familiarity with SQL / Databricks is a plus
Benefits
Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
About Monogram Health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.