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Jefferson Health · 5 months ago

Chief Actuary, Jefferson Health Plans

Philadelphia, PA

Full-time

Onsite

Director/Executive

10+ years exp

Jefferson Health is a nationally ranked health care system seeking a Chief Actuary to lead actuarial strategy across government-sponsored health programs. The role involves overseeing pricing strategy, ensuring regulatory compliance, and leading a high-performing actuarial team to drive financial performance and sustainable growth.

Hospital & Health Care

Responsibilities

Own and oversee pricing strategy and rate development for Medicare, and ACA products, ensuring competitiveness and compliance with regulatory requirements

Evaluate and rationalize the division of pricing responsibilities between internal actuarial teams and external consultants, particularly for ACA and Medicare lines of business

Develop a roadmap to transition appropriate pricing functions in-house where it adds strategic value, enhances agility, or improves cost-efficiency, while maintaining strong oversight of consultant-delivered work

Ensure pricing methodologies are actuarially sound, data-driven, and aligned with both regulatory expectations and enterprise financial goals

Lead the development of actuarial reserves and financial forecasts, ensuring accuracy, transparency, and alignment with corporate financial goals

Analyze medical cost trends and utilization patterns to inform business strategy, product design, and cost containment initiatives

Partner with Finance, Clinical, Product, and Regulatory teams to translate actuarial insights into actionable business strategies

Serve as the actuarial point of contact for state and federal regulators, ensuring timely and accurate submissions and responses

Build, lead, and mentor a high-performing actuarial team, with a focus on recruiting top talent and expanding internal capabilities

Champion the use of advanced analytics and predictive modeling to enhance pricing accuracy and operational efficiency

Qualification

FSA designationActuarial modeling softwarePricing strategyRegulatory frameworksTrend analysisData-driven decision makingLeadership skillsStakeholder managementCommunication skillsStrategic thinking

Required

Bachelor's degree in actuarial science, mathematics, statistics, or related field

FSA (Fellow of the Society of Actuaries) designation required

10 + years of actuarial experience in health insurance, with significant leadership in government programs (Medicaid, Medicare, CHIP, ACA)

Proficient in actuarial modeling software (e.g., SQL, SAS, R, Python, Excel, VBA)

Experience in building or reviewing models related to pricing, reserving, and risk adjustment

Proven track record in pricing, reserving, and trend analysis

Strong understanding of regulatory frameworks and rate filing processes

Exceptional leadership, communication, and stakeholder management skills

Experience working in a matrixed or highly collaborative organizational structure

Strategic thinker with the ability to translate complex data into business insights

Preferred

Master's degree in actuarial science, mathematics, statistics, or related field

Benefits

Medical (including prescription)

Supplemental insurance

Dental

Vision

Life and AD&D insurance

Short- and long-term disability

Flexible spending accounts

Retirement plans

Tuition assistance

Voluntary benefits

Company

Jefferson Health

Thomas Jefferson University and Thomas Jefferson University Hospitals are partners in providing excellent clinical and compassionate care for our patients in the Philadelphia region, educating the health professionals of tomorrow in a variety of disciplines and discovering new knowledge that will define the future of clinical care.

Founded in 1995

Philadelphia, PA, US

5001-10000 employees