VP and Chief Actuary

About this role

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

The Vice President, Chief Actuary serves as the organization's senior actuarial executive and strategic business advisor, responsible for leading enterprise actuarial services, underwriting, risk management, and actuarial analytics across all lines of business. This role ensures the financial sustainability, pricing integrity, and regulatory compliance of PacificSource's health plans through actuarially sound forecasting, reserving, risk assessment, and market analysis. As a member of the Executive Management Group (EMG), the Chief Actuary provides strategic guidance on growth initiatives, product development, value-based care arrangements, provider reimbursement strategies, capital planning, enterprise risk management, administrative budget planning, FP&A partnership, and long-term financial performance. The role partners closely with Finance, Financial Planning & Analysis (FP&A), Health Services, Provider Network, Government Programs, Operations, Sales, and Executive Leadership to support organizational objectives and improve affordability, quality, and member outcomes.

Essential Responsibilities: • Lead enterprise actuarial strategy and advise executive leadership and the Board on pricing, financial risk, market trends, capital requirements, growth opportunities, and long-term financial performance. • Direct actuarial functions across pricing, forecasting, reserving, trend analysis, risk modeling, underwriting support, financial performance evaluation, and scenario modeling. • Ensure actuarially sound premium development, IBNR reserves, Statements of Actuarial Opinion, regulatory certifications, and compliance with applicable actuarial standards of practice. • Monitor healthcare utilization, cost trends, and emerging risks; recommend strategies to mitigate financial risk and support strategic decision-making. • Lead actuarial support for Enterprise Risk Management, Own Risk and Solvency Assessment, and other risk activities, including evaluation of financial, operational, clinical, and market risks. • Ensure compliance with state and federal regulatory requirements, accreditation requirements, and actuarial standards while maintaining effective relationships with regulators, auditors, rating agencies, and consulting actuaries. • Lead actuarial evaluation, pricing, and financial impact analysis for new products, benefit designs, regulatory changes, market opportunities, and evolving healthcare delivery models. • Partner with Product Development, Sales, Marketing, Government Programs, and other leaders to support competitive positioning and strategic growth across Individual, Medicare Advantage, Medicaid, and Commercial markets. • Partner with key leaders to develop, evaluate, and support value-based reimbursement arrangements, risk-sharing agreements, provider incentive programs, and alternative payment models. • Analyze provider performance, quality outcomes, cost of care trends, and clinical program effectiveness to support affordability, population health, and return on investment. • Oversee actuarial analytics, predictive modeling, business intelligence, and data-driven insights to identify financial opportunities, emerging risks, and market trends. • Collaborate with data and technology teams to advance analytical capabilities, modernization initiatives, and timely reporting for executive decision-making. • Provide leadership, direction, coaching, and professional development for actuarial and underwriting staff, including staffing, performance management, succession planning, and talent development. • Build a high-performing culture of accountability, collaboration, innovation, and continuous improvement while managing departmental operating and capital budgets. • Oversee administrative budget planning and performance for assigned functions, including expense forecasting, variance analysis, resource allocation, and alignment of departmental spending with enterprise priorities. • Partner with Accounting and oversee FP&A to support annual and long-range financial planning, budget development, financial forecasting, performance reporting, cost-benefit analysis, and evaluation of financial impacts associated with strategic initiatives. • Participate in strategic and internal committees to share information, represent organizational priorities, and support alignment across the company.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations. • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. • Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: At least 10 years’ years of progressive actuarial leadership experience within healthcare, health insurance, managed care, or related industries, to include at least 4 years in a leadership role. Experience with Medicare Advantage, Medicaid, ACA Marketplace, and risk adjustment programs. Experience supporting value-based care and alternative payment models. Experience managing multiple actuarial disciplines and business functions.

Education, Certificates, Licenses: Baccalaureate degree in business, mathem

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