Senior Director, Actuarial - Risk Adjustment

Posted Yesterday
Be an Early Applicant
Hiring Remotely in USA
Remote
197K-287K Annually
Senior level
Healthtech • Insurance
Give people power over their healthcare.
The Role
Leads Oscar’s ACA risk adjustment actuarial function, overseeing financial reporting, forecasting, risk score and morbidity analysis, executive reporting, advanced analytics, cross-functional strategy, and actuarial team development. The role advises senior leadership on pricing, growth, network strategy, market dynamics, and financial implications while managing partnerships across Finance, Operations, Medical Economics, and Data Science.
Summary Generated by Built In

Hi, we're Oscar. We're hiring a Senior Director, Actuarial - Risk Adjustment to join our Actuarial team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Senior Director, Actuarial – Risk Adjustment leads Oscar's ACA risk adjustment actuarial function, with responsibility for financial reporting, forecasting, and strategic analysis. You manage a team and partners across Finance, Market P&L, Risk Adjustment Operations, Medical Economics, and Data Science to inform business strategy and financial disclosures. You will translate risk adjustment performance, market dynamics, and financial implications into clear, actionable insights for senior leadership.

You will report to the Vice President, Corporate Actuarial.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $218,592 - $286,902 per year. The base pay for this role in all other locations is: $196,733 - $258,212 per year.. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

  • ACA Risk Adjustment Financial Reporting & Forecasting: Lead financial reporting and forecasting for ACA risk adjustment, including monthly close, external audits, regulatory reviews, and other finance-related activities.
  • Oscar Risk Score Analysis & Projection: Develop strategic insights and projections regarding Oscar's ultimate risk scores and risk adjustment performance.
  • Market Morbidity Analysis & Projection: Analyze market morbidity drivers and their financial implications, coordinating with key external stakeholders including industry consultants.
  • Executive Advising & Reporting: Lead executive-facing reporting by managing key financial forecasts and delivering presentations that translate complex actuarial insights into actionable strategic recommendations for senior leadership.
  • Cross-Functional Leadership: Build strategic partnerships across key business units (e.g., Finance, Risk Adjustment Operations, Market P&L) and represent the Actuarial function in executive forums.
  • Advanced Analytics & Growth: Direct advanced analytics initiatives, leveraging key findings to shape enterprise-wide decision-making regarding pricing, strategic business growth, and network strategies.
  • Team Management & Development: Lead and develop a team of actuarial professionals, providing coaching, mentorship and professional development to foster continuous growth across the Actuarial team.
  • Other duties as assigned.

Requirements:

  • Bachelor's degree in a STEM field, or 4 years commensurate experience.
  • 12+ years of quantitative analysis in the healthcare industry.
  • 5+ years of collaborating and influencing an Executive Leadership Committee.
  • Proven experience in a pricing role, or a related analytics-driven leadership role.
  • Strong government programs risk adjustment subject matter expertise, preferably in ACA Marketplace.

Bonus points:

  • Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment.
  • Qualified (or willing to become qualified) to serve as appointed actuary for insurance companies the American Academy of Actuaries’ Specific qualification standard.
  • Excellent communication, collaboration, and relationship-building skills.
  • Strong process management skills, with experience streamlining workflows and driving operational efficiency.
  • Collaborative and influential leadership style, with experience partnering across multiple teams and stakeholders.
  • Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements.
  • Fellow of the Society of Actuaries (SOA), or on the track to become one.

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

Skills Required

  • Bachelor's degree in a STEM field or four years of commensurate experience
  • 12 or more years of quantitative analysis experience in the healthcare industry
  • Five or more years collaborating with and influencing an Executive Leadership Committee
  • Proven experience in a pricing role or related analytics-driven leadership role
  • Strong subject matter expertise in government programs risk adjustment, preferably ACA Marketplace
  • Extensive experience leading actuarial financial reporting, including claims reserving and risk adjustment
  • Qualified or willing to become qualified to serve as an appointed actuary under the American Academy of Actuaries' standards
  • Excellent communication, collaboration, and relationship-building skills
  • Strong process management skills and experience streamlining workflows and driving operational efficiency
  • Collaborative and influential leadership style with experience partnering across multiple teams and stakeholders
  • Familiarity with ACA-specific healthcare laws, regulations, and compliance requirements
  • Fellow of the Society of Actuaries or on the track to become one

Oscar Health Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Oscar Health and has not been reviewed or approved by Oscar Health.

  • Healthcare Strength — Employer-sponsored medical coverage for employees and their families with mental-health support is prominently offered. Wellness programming and digital care access add to perceived strength.
  • Parental & Family Support — Paid parental leave of 10+ weeks, backup care, and family-forming support (including fertility and adoption benefits) are part of the package. Reproductive‑loss leave is also noted.
  • Leave & Time Off Breadth — Multiple time‑off options, wellness days, and an unlimited vacation program for some roles are described. Paid holidays, paid sick time, and a long‑tenure sabbatical broaden time‑away choices.

Oscar Health Insights

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The Company
HQ: New York, NY
2,400 Employees
Year Founded: 2012

What We Do

Oscar Health, Inc. (NYSE: OSCR) is a leading consumer health company that gives people power over their healthcare. Oscar Health serves millions of consumers, employers, brokers, and partners through Oscar Insurance, Lucie Health Marketplace, and Trove Group. Together these businesses deliver exceptional lifestyle products and technology platforms that make healthcare easy to choose, use, and experience.

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