Senior Director Actuarial Services, Group Medicare Advantage – Remote
(Remote considered)
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Imagine how much went in to forming a team of actuarial talent that can keep our Fortune 5 global organization at the forefront of an industry. It took a lot of planning and work, and it is a great start. But now we need you.
The Senior Director Actuarial Services, Group Medicare Advantage will lead the actuarial strategy and delivery for our Group Medicare Advantage (employer group/retiree) portfolio. You will oversee pricing, trend analytics, competitive intelligence, and reporting that power our growth and ensure affordability for employer clients and retirees. This role blends strategic leadership with hands-on actuarial excellence, modern analytics, and solid cross‑functional partnership with Underwriting, Finance, Product, Medical Economics, and Network.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Own Group Medicare Advantage pricing strategy and execution for employer group/retiree plans; ensure timely, accurate deliverables aligned with business goals and regulatory requirements
- Lead Group Retiree actuarial reporting, advanced analytics, and data validation to support MA pricing and financial decisions
- Provide direction for competitive analysis; translate market and competitor moves into clear pricing implications and product recommendations
- Oversee the development and governance of actuarial pricing models, methodologies, and assumptions; incorporate machine learning/AI tools where they add accuracy, speed, and explainability
- Build and standardize reporting that keeps Underwriting and Finance current on trend drivers, PMPM, MLR, membership mix, and forecast vs. plan; introduce automated dashboards and early‑warning signals
- Lead medical trend analytics: decompose utilization, unit cost, and mix; quantify uncertainty; run scenarios for fee schedules, contracting changes, benefit design, and UM policies
- Direct risk adjustment analytics (HCC modeling, RAF monitoring, normalization/coding intensity); ensure pricing and forecasting reflect current CMS guidance
- Partner with Network/Contracting and Medical Economics to translate provider agreements, site‑of‑care shifts, and policy changes into pricing and trend assumptions
- Establish solid actuarial governance: ASOP compliance, peer review, documentation, model risk controls, and audit readiness
- Lead and mentor a small team of actuaries and analysts; foster a culture of inclusion, development, and continuous improvement
- Communicate results and recommendations to VP and cross‑functional leaders with clear, actionable storytelling
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Bachelor’s degree
- ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) designation
- 5+ years of progressive health actuarial experience
- 3+ years of experience managing direct reports
- Experience working with healthcare plans, preferable pricing
- Advanced or higher level of proficiency in MS Excel
- Beginner or higher level of proficiency in SAS (Statistical Analysis System), SQL (Structure Query Language), R, Python, or other programming system
- Proven track record in trend analysis, competitive intelligence and translating insights into pricing and product strategy
Preferred Qualifications:
- EGWP/Part D experience
- Familiarity with applying ML/AI responsibly in actuarial workflows
- Deep expertise in Medicare Advantage pricing
- Proficiency with BI tools (Tableau/PowerBI)
- Proven command of Medicare Advantage regulatory landscape (e.g. HCC/RAF, fee schedules, MLR, Stars/HEDIS impacts)
- Proven excellent communication skills, stakeholder management and executive presence; ability to influence decisions in a matrixed environment
- Proven commitment to rigorous governance, documentation and data quality
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $156,400 to $268,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
Información adicional sobre la vacante
Número de la requisición 2305360
Segmento de negocio UnitedHealthcare
Nivel del cargo Director
Disponibilidad para viajar Yes, 10 % of the Time
País US
Estado de horas extras Exempt
Vacante de teletrabajo Yes