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Director, Value Based Care Pricing Actuary
AGIA AffinityExperienced actuary evaluating and pricing Aggregate Excess of Loss opportunities in value-based care. Working with healthcare provider organizations and shaping underwriting strategy.
About the role
Key responsibilities & impact- Partner directly with underwriting leadership to evaluate and price Aggregate Excess of Loss opportunities
- Assess provider risk arrangements involving Medicare Advantage, Commercial, Medicaid, and other value-based care programs
- Analyze healthcare claims experience, provider performance, and financial risk-sharing structures
- Develop actuarial models and pricing methodologies to support underwriting decisions
- Identify and evaluate emerging opportunities within value-based care markets
- Provide insight into payer-provider relationships, reimbursement structures, risk adjustment, and performance incentives
- Help establish underwriting guidelines and risk selection frameworks for new market opportunities
- Support portfolio management efforts by monitoring trends, profitability, and volatility across the book of business
- Serve as a trusted subject matter expert with carrier partners and internal stakeholders
- Collaborate with leadership on strategic growth initiatives and market expansion opportunities
Requirements
What you’ll need- ASA or FSA designation (or equivalent actuarial credentials)
- 7+ years of actuarial experience within: A major health payer, A healthcare consulting organization with significant value-based care exposure
- Deep expertise in value-based care programs and provider risk arrangements
- Strong understanding of healthcare claims analytics, risk adjustment, medical economics, and population health management
- Experience supporting Medicare Advantage, Commercial, Medicaid, ACO, MSSP, or similar risk-bearing programs
- Advanced analytical and modeling capabilities
Benefits
Comp & perks- Flexible remote work environment
- Competitive compensation (based on experience)
- Comprehensive benefits package: Medical, dental, vision, Life & long-term disability insurance, 401(k) with company match
- Generous PTO and sick time
- Career advancement within a growing specialty insurance platform
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
actuarial modelingpricing methodologieshealthcare claims analyticsrisk adjustmentfinancial risk-sharing structuresadvanced analytical capabilitiesmodeling capabilities
Soft Skills
collaborationstrategic growth initiativescommunicationleadership
Certifications
ASA designationFSA designation