Vice President of Actuary

Job Ref: TE0074
Category: Finance
Department: FINANCE ADMININSTRATION
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Hybrid
Salary Range: $270,000.00 - $280,000.00

Position Overview

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

The Vice President of Actuary is a principal actuary who services and has authority for risk oversite, reserve adequacy, medical cost forecasting, and advanced predictive modeling across all lines of business. This role provides independent actuarial judgement on financial risk, pricing, and directly advises the Chief Financial Officer (CFO) on emerging risk signals and long-term financial sustainability.

The position oversees actuarial methodologies that material impact multi-billion-dollar revenue streams and balance sheet reserves. 

 

Scope of Role & Responsibilities

• Provide independent actuarial oversight of pricing, reserving, trend, across commercial, Medicaid, Medicare and other government programs.
• Lead and opine on reserve adequacy (IBNR, UCL, completion factors) and ensure actuarial standards of practice are met.
• Lead enterprise stress testing and financial scenario modeling to assess downside exposure and rate sufficiency.
• Quantify financial risk under alternative regulatory, utilization, and reimbursement assumptions.
• Direct enterprise medical cost trend forecasting and emerging experience analysis.
• Identify and quantify cost drivers, utilization shifts, acuity changes, and provider performance variation.
• Oversee development of performance metrics for Value-Based Payment (VBP) arrangements.
• Translate complex actuarial findings into actionable financial and strategic insights.
• Lead development, validation, and governance of predictive models supporting revenue optimization, utilization and cost forecasting, high cost claimant risk stratification, pricing strategy.
• Establish model governance frameworks ensuring data integrity, reproducibility and regulatory defensibility. 
• Partner with data science and analytics to operationalize models at scale.
• Serve as principal actuarial advisor to CFO.
• Provide actuarial impact assessment for strategy, filings, VBP, and reimbursement structures.
• Support long range financial planning through actuarial projections and multi-year forecasting models.
• Present findings to board level stakeholders and regulaotry bodies as needed. 
• Ensure compliance with ASOP.
• Support filings, rate submissions, and audit inquiries.
• Oversite of actuarial methodologies influencing multi-billion-dollar revenue streams.
• Direct influence on pricing adequacy, MLR.
• Accountable for actuarial risk mitigation strategies affecting organizational financial performance trends

 

Required Education, Training & Professional Experience

• A Bachelor’s Degree with a specialization in Finance, Health Care Administration, or a related field; and
• 12-15 years of progressive actuarial experience; or
• An equivalent combination of training, education and experience in health insurance financial operations, managed healthcare or related fields and educational disciplines; and,
• Thorough knowledge of the fundamentals of health insurance administration and standards, regulations and laws applicable to health insurance operations, knowledge of business and human resources administration principles, management functions, management processes and functions of health insurance departments, and experience directing and supervising personnel. Must have Bachelor’s Degree at minimum.

 

Licensure and/or Certification Required

• Fundamentals of Sustainability Accounting (FSA) certification as issued by the IFRS Foundation is required.

 

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication

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