Director, Actuarial Services

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.