About this opportunity
Sentara Healthcare Inc lists this Director, Actuarial opportunity in norfolk, Virginia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
The Director, Actuarial – Government Programs will lead actuarial pricing, financial performance insights, and strategic analytics across SHP’s Medicare and Medicaid lines of business. This role is critical to ensuring market-competitive, compliant, and financially sustainable products while translating actuarial insights into actionable business decisions.
This leader will operate in a highly matrixed environment, partnering closely with Finance, Product, Network, Risk Adjustment, and Clinical teams to drive enterprise value and support SHP’s growth strategy.
Core Responsibilities
1. Government Programs Pricing & Financial Management
Lead end-to-end pricing for Medicare Advantage, Medicaid, and related government programs
Develop and maintain actuarial assumptions, methodologies, and pricing models
Ensure rate adequacy, competitiveness, and alignment with enterprise financial targets
Oversee bid development, rate filings, and regulatory submissions
2. Forecasting & Performance Insights
Translate pricing assumptions into forward-looking financial projections and scenarios
Monitor emerging experience vs. pricing assumptions and identify key drivers of variance
Provide actionable insights to improve margin, membership growth, and cost management
3. Regulatory & Compliance Leadership
Ensure compliance with CMS, state Medicaid agencies, and insurance department requirements
Support actuarial certifications, rate filings, and audit readiness
Interface with regulators and external actuarial partners as needed
4. Strategic Partnership & Cross-Functional Leadership
Partner with Product, Network/Provider Contracting, and Clinical teams on: Benefit design and product strategy
Value-based care and provider reimbursement models
Cost of care and utilization management strategies
Align actuarial assumptions with operational and market realities across the enterprise
5. Team Leadership & Talent Development
Lead and develop a high-performing team of actuaries and analysts
Establish clear priorities, governance, and quality standards for actuarial work products
Foster a culture of innovation, continuous improvement, and accountability
6. Enterprise Contribution & Thought Leadership
Contribute to enterprise planning, budgeting, and long-term strategy
Present insights and recommendations to senior leadership in a clear, actionable manner
Identify opportunities for automation, analytics advancement, and process optimization
Qualifications
Bachelor's Degree Required.
5 years Management experience.
7 years Actuarial experience.
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Worksite address
norfolk, VA, 23500, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.