Health Care Service Corporation · 1 week ago
Executive Director, Actuarial
Chicago, IL
Full-time
Onsite
Senior Level, Lead/Staff
$162K/yr - $300K/yr
10+ years expHealth Care Service Corporation (HCSC) is a purpose-driven company focused on employee development and career fulfillment. The Executive Director, Medicare Part D Actuarial will lead the actuarial function for Medicare Part D products, overseeing product strategy, pricing, and financial performance while acting as a key partner to senior leaders across various departments.
Health InsuranceInsurance
Responsibilities
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
Establish and maintain strong actuarial governance, controls, and documentation standards to support regulatory and audit requirements
Act as the primary actuarial point of contact for external actuarial vendors and consultants
Oversee vendor scope, deliverables, timelines, and quality, ensuring alignment with business objectives and regulatory expectations
Leverage external partnerships to enhance modeling sophistication, analytics, and strategic decision-making
Lead, mentor, and develop a high-performing actuarial team supporting Medicare Part D
Foster a culture of accountability, collaboration, and continuous improvement, with a focus on developing future actuarial leaders
Set clear priorities, performance expectations, and development plans aligned with organizational goals
Qualification
Required
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
Translating needs and initiatives into compelling business cases
Conducting cost-benefit analyses to justify investments and ensure ROI
Preferred
Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related field; advanced degree preferred
FSA designation
10+ years of progressive actuarial experience, including significant leadership responsibility in Medicare Part D
Deep expertise in Medicare Part D pricing, bid development, forecasting, and regulatory requirements
Strong strategic influence, executive presence, and financial acumen
Strong understanding of pharmacy benefit economics, including formulary and network strategy impacts
Proven experience leading CMS bid audits and financial audits, and partnering with external actuarial firms
Demonstrated ability to communicate complex actuarial and financial concepts clearly to senior leaders and non-technical stakeholders
Company
Health Care Service Corporation
Health Care Service Corporation is a customer-owned health insurance company.
10001+ employees
H1B Sponsorship
Health Care Service Corporation has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (198)
2024 (166)
2023 (132)
2022 (145)
2021 (73)
2020 (59)
Funding
Current Stage
Late StageLeadership Team
Manika Turnbull
Senior Vice President & Chief Human Resources Officer
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