Director of Actuarial Models Job at Robert Half (Albany)

Director, Value-Based Analytics & Actuarial Strategy

SpectraMedix is seeking an accomplished professional with an actuarial or advanc...

Location

United States , NJ

Salary:

Not provided

SpectraMedix

Expiration Date

Until further notice

Requirements

Bachelor’s or Master’s degree in Actuarial Science, Statistics, Mathematics, Health Economics, or related field
12+ years of experience in actuarial, financial, or value-based analytics roles within a consulting firm, health plan, ACO, or healthcare analytics organization
Proven understanding of value-based contracting, risk adjustment, quality metrics, and payment reconciliation processes
Strong data literacy—experience working with healthcare data (claims, cost, quality, utilization) and proficiency with analytical tools (SQL, R, Python, Excel, Power BI, etc.)
Excellent communication skills with the ability to engage payer and provider executives and translate complex analytics into actionable strategy
This role involves approximately 20–25% travel, so you should be comfortable with occasional work-related travel
Hands-on exposure to Cloud technologies, particularly Azure, AWS, and Databricks

Job Responsibility

Partner with health plans, ACOs, and health systems to design, evaluate, and enhance value-based care programs (e.g., shared savings, global capitation, incentive models)
Lead actuarial and financial analytics supporting contract modeling, risk adjustment, benchmarking, and performance measurement across multiple lines of business (Medicaid, Medicare, Commercial)
Translate analytical findings into strategic insights for clients—supporting contract development, performance improvement, and program optimization
Collaborate with internal teams (product, engineering, and client delivery) to shape product strategy and ensure that data-driven capabilities align with evolving market needs
Serve as a client-facing subject matter expert in value-based contracting, risk modeling, and performance analytics
Assist clients with defining their value-based strategy and defining an ROI
Contribute to business development activities by supporting client presentations, proposals, and thought leadership initiatives
Stay current with CMS, state Medicaid, and commercial VBP policy trends, including interoperability and quality measurement standards (HEDIS, eCQMs, DaVinci, MCP, etc.)
Be a strategic thought leader within the Company to help scale SpectraMedix into the leader in VBC software applications

What we offer

Competitive compensation, benefits, and professional growth opportunities

Executive Director, Actuarial

The Executive Director, Medicare Part D Actuarial will lead the actuarial functi...

Location

United States , Chicago; Richardson

Salary:

161500.00 - 299700.00 USD / Year

Health Care Service Corporation

Expiration Date

Until further notice

Requirements

Bachelor’s degree in business, Finance, Actuarial Science, Mathematics, Economics, Computer Science or Management Information Systems
10 years of data, transactional application-based knowledge or group health underwriting experience
10 years of management experience, including overseeing two or more departments led by managers
Experience in leading one or more major (multi year) group insurance implementation projects
Experience in leading one of the following: Actuarial Systems or Applications and systems related teams including testing, building, and writing requirements
Experience in quality and auditing and system testing (including creating test scripts)
Experience planning skills including: Setting goals at a position appropriate level, long term planning (one year or longer), budget and expense management, creating staffing models for up to 2 years, establishing department vision
Problem solving, negotiation skills, and organizational alignment
Clear and concise verbal and written communication skills. Experience presenting to all levels of management including audiences with diverse communications preferences
Overseeing the annual budget and allocating resources for various projects and operational needs

Job Responsibility

Lead actuarial strategy for Individual MAPD and PDP products, ensuring financial sustainability, regulatory compliance, and competitive market positioning
Provide actuarial leadership on product strategy and component strategies, including benefits, formulary, rebate, network, and mail, balancing affordability, growth, and margin objectives
Partner cross-functionally with Pharmacy, Product, Finance, Compliance, and Operations to align actuarial assumptions with enterprise strategy
Oversee end-to-end Medicare Part D bid development and submission, including pricing, assumptions, documentation, and internal governance approvals
Lead quarterly forecast updates and support monthly close activities, ensuring accuracy, transparency, and alignment between actuarial projections and financial results
Provide actuarial support for annual PBM market checks and negotiations
Identify key financial risks and opportunities, proactively communicating insights and recommendations to executive leadership
Lead Medicare Part D market intelligence, including competitor analysis, CMS policy changes, regulatory guidance, and industry trends
Translate market insights into actionable recommendations for product design, pricing strategy, and long-term Medicare positioning
Serve as actuarial lead for CMS bid audits, internal audits, and financial audits, ensuring defensibility of assumptions, data integrity, and timely responses

Fulltime

Financial Risk Management Associate Director

This is an opportunity to move beyond routine reporting and step into the forefr...

Location

Malaysia , Kuala Lumpur

Salary:

14000.00 - 22000.00 MYR / Month

Randstad

Expiration Date

February 13, 2026

Requirements

Minimum 10+ years of relevant experience (Associate Director) or 14+ years (Director)
Degree in Mathematics, Statistics, Actuarial Science, Economics, Engineering, Finance, or Computer Science
Hands-on experience in the design and development of risk models, methodologies, or solutions
Strong understanding of banking products, credit management, and financial regulations
Ability to develop or validate Credit, Market, or Operational risk measurement models
Proven track record in a supervisory or project management role, preferably within a consulting or banking environment
Strong report writing and presentation skills
Self-initiated and solution-focused mindset
Capable of conducting independent research

Job Responsibility

Lead large-scale risk transformation projects from inception to go-live, managing timelines, budgets, and internal risk processes
Act as the primary advisor to client management
Oversee the full lifecycle of risk technology implementation
Act as the Technical Lead in one of the following core areas: Regulatory & Capital (Basel 3/4), Credit Risk, Market Risk & Valuation, ALM & Treasury
Drive growth by engaging with CROs and CFOs to anticipate client needs
Serve as a Performance Manager, guiding team members in both their technical expertise and career progression

Senior Actuarial Leader (P&C)

Goodman Masson are excited to be partnered with a highly prominent global organi...

Location

Bermuda

Salary:

300000.00 - 400000.00 USD / Year

Goodman Masson

Expiration Date

Until further notice

Requirements

Highly experienced Leader
Strong Reserving focus
Reinsurance knowledge desirable
Exposure to Pricing, ILS, Capital Modelling and Risk
Previous experience of working within the Bermuda market advantageous
Based in the UK or USA (relocation support and visa sponsorship provided)
Previously worked as Chief Actuary for a prominent Insurer or at Director level for a Consulting practice

Job Responsibility

Take ownership of their P&C division in Bermuda
Continue growing and developing the team

What we offer

Relocation support
Visa sponsorship

Director, Health & Welfare

The Director, Health & Welfare role involves shaping and communicating the strat...

Location

United States , Bethesda

Salary:

157700.00 - 191200.00 USD / Year

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

8+ years experience in designing and managing health + welfare benefits for complex organizations with a strong focus on innovative solutions, employee experience and financial management
Strong decision-making and organizational skills, with the ability to optimize the use of all available resources and deliver on multiple priorities
Skilled in stakeholder management, as well as proven ability to build and facilitate relationships and influence others at all levels of the organization, both internally and externally

Job Responsibility

Help shape and communicate short- and long-term strategy, program design and goals for health and welfare programs
Leverage data, insights, and trends to inform plan design and strategy
Manage vendor relationships, contractual terms and operations to deliver an exceptional experience and manage costs
Proactively stay current on industry best practices, legislative changes, and periodic market evaluations, to ensure programs are optimized, compliant and to develop recommendations for change
Partner with Benefits and finance leaders and actuaries to develop self-insured plan pricing, help shape the company contribution strategy for health and welfare programs and lead the related financial modeling, analysis, and reporting
Collaborate with Senior HR Leadership teams ensuring cost-effectiveness and fiscal responsibility for stakeholders
Lead large-scale change initiatives with a focus on internal and external stakeholder engagement, seamless integration, risk management and operational excellence and adherence to health and welfare program provisions
Evaluate health and welfare plan performance to identify trend drivers and recommend strategic opportunities and solutions to address findings
Collaborate with internal and external stakeholders to promote health and welfare programs, drive engagement, and support holistic well-being

What we offer

Bonus program
Comprehensive health care benefits
401(k) plan with up to 5% company match
Employee stock purchase plan at 15% discount
Accrued paid time off (including sick leave where applicable)
Life insurance
Group disability insurance
Travel discounts
Adoption assistance
Paid parental leave

Fulltime

New

Senior Director, Insurance AI Innovation & GTM Advisory

The Senior Director, Insurance AI Innovation & GTM Advisory will lead the commer...

Location

Canada

Salary:

158000.00 - 294000.00 CAD / Year

NTT DATA

Expiration Date

Until further notice

Requirements

Bachelor's degree in a relevant technical field (e.g., Computer Science, Engineering, Actuarial Science)
Deep Insurance Domain Expertise: Extensive experience working within the P&C or L&A insurance industries, with a strong understanding of core value chains (underwriting, policy servicing, claims)
GTM & Commercial Acumen: Proven track record in a GTM, product marketing, or solutions engineering role for a technical product sold into the financial services/insurance sector
Strong Technical Background: Proficiency in software engineering principles, including Python, APIs, SQL, and data pipelines. Experience delivering production-ready technical solutions within enterprise environments is essential
AI Knowledge: Deep understanding of agentic AI frameworks, Large Language Models (LLMs), and how they can be practically applied to solve insurance business challenges
Client-Facing Skills: Excellent communication skills with the ability to build trust and translate complex technical concepts into clear business value for executive and technical stakeholders alike

Job Responsibility

Develop and execute a tailored GTM strategy for the P&C and L&A sectors, identifying key use cases (e.g., automated claims routing, risk assessment automation) and defining targeted value propositions
Collaborate with marketing, sales, product, and engineering teams to build differentiating capabilities and revenue-driving initiatives
Develop compelling, industry-specific collateral, case studies, and demos that resonate with insurance professionals
Analyze insurance industry trends and competitive landscapes to ensure our platform maintains a leading edge in functionality and compliance
Collaborate directly with senior client stakeholders to understand specific P&C/L&A infrastructure and pain points, architecting bespoke AI solutions
Serve as the subject matter expert for defining workflows—underwriting, claims, policy admin, actuarial, billing, customer service, agent engagement, fraud, and compliance
Lead the end-to-end delivery of complex AI solutions within client environments
Act as the primary technical advisor, guiding clients through the complexities of deploying novel AI solutions while navigating compliance and data privacy requirements
Provide actionable, domain-specific feedback to internal Product and Engineering teams to refine the platform roadmap for the insurance vertical

What we offer

Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in retirement savings programs, and additional voluntary or legally required benefits

Fulltime

Director, Payment Integrity

The Director, Payment Integrity provides strategic leadership and oversight for ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

10 years of experience in Payment Integrity, Special Investigation Unit, or healthcare anti-fraud
7+ years of experience in management role
2+ years of experience in Vendor Partner Oversight
contracting and vendor management of external payment vendors and/or audit firms
Demonstrated success in developing and executing enterprise-wide strategies
Bachelor's Degree in business, statistics, healthcare administration or related field of study
Intermediate PC proficiency
Intermediate skill in use of office equipment
Basic skill in word processing and presentation software
Intermediate proficiency in spreadsheet, statistical analysis, query / data mining, and business intelligence software

Job Responsibility

Develop and execute enterprise-wide Payment Integrity strategy aligned with organizational objectives and cost of care targets
Lead the design, implementation, and continuous improvement of payment integrity programs, including pre- and post-payment audits, recovery, and investigative functions
Establish and maintain governance structures, including cross-functional committees, to oversee payment integrity controls and policy development
Representing the organization in internal and external forums, collaborating with industry peers, regulatory bodies, and vendor partners to share best practices and drive innovation
Stay abreast of emerging trends, technologies, and regulatory shifts in the healthcare payment integrity space
Oversee day-to-day operations, ensuring timely, accurate, and compliant claims payment and recovery activities
Direct vendor management, including contracting, performance oversight, and strategic partnerships for payment integrity solutions
Drive automation and technology adoption to enhance payment integrity processes and reporting capabilities
Lead cost-benefit analyses to determine optimal resource allocation (internal vs. outsourced functions)
Set and monitor KPIs, SMART goals, and financial targets for payment integrity initiatives

Fulltime

New

Director, Payment Integrity

The Director, Payment Integrity provides strategic leadership and oversight for ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

10 years of experience in Payment Integrity, Special Investigation Unit, or healthcare anti-fraud
7+ years of experience in management role
2+ years of experience in Vendor Partner Oversight
contracting and vendor management of external payment vendors and/or audit firms
Demonstrated success in developing and executing enterprise-wide strategies
Bachelor's Degree in business, statistics, healthcare administration or related field of study
Intermediate PC proficiency
Intermediate skill in use of office equipment
Basic skill in word processing and presentation software
Intermediate proficiency in spreadsheet, statistical analysis, query / data mining, and business intelligence software

Job Responsibility

Develop and execute enterprise-wide Payment Integrity strategy aligned with organizational objectives and cost of care targets
Lead the design, implementation, and continuous improvement of payment integrity programs, including pre- and post-payment audits, recovery, and investigative functions
Establish and maintain governance structures, including cross-functional committees, to oversee payment integrity controls and policy development
Representing the organization in internal and external forums, collaborating with industry peers, regulatory bodies, and vendor partners to share best practices and drive innovation
Stay abreast of emerging trends, technologies, and regulatory shifts in the healthcare payment integrity space
Oversee day-to-day operations, ensuring timely, accurate, and compliant claims payment and recovery activities
Direct vendor management, including contracting, performance oversight, and strategic partnerships for payment integrity solutions
Drive automation and technology adoption to enhance payment integrity processes and reporting capabilities
Lead cost-benefit analyses to determine optimal resource allocation (internal vs. outsourced functions)
Set and monitor KPIs, SMART goals, and financial targets for payment integrity initiatives

Fulltime

Director of Actuarial Models

Robert Half

Location:
United States , Albany

Category:
Finance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 26, 2026

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