[Hiring] Senior Director, Actuarial - Risk Adjustment @Oscar Health

Role Description

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

• Lead financial reporting and forecasting for ACA risk adjustment, including monthly close, external audits, regulatory reviews, and other finance-related activities.
• Develop strategic insights and projections regarding Oscar's ultimate risk scores and risk adjustment performance.
• Analyze market morbidity drivers and their financial implications, coordinating with key external stakeholders including industry consultants.
• Lead executive-facing reporting by managing key financial forecasts and delivering presentations that translate complex actuarial insights into actionable strategic recommendations for senior 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.
• Direct advanced analytics initiatives, leveraging key findings to shape enterprise-wide decision-making regarding pricing, strategic business growth, and network strategies.
• 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.

Qualifications

• 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.

Requirements

• 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.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.