Associate Director, Actuarial Strategy

Summary

Join Abarca, a revolutionary healthcare company, as the Associate Director, Actuarial Strategy. Lead the development and execution of data-driven strategic initiatives, creating pivotal models to explain current financial impacts and predict future spending. Transform complex medical and pharmacy data into actionable insights and financial strategies. Serve as a senior thought leader, leveraging actuarial expertise and advanced analytics to inform enterprise decisions and drive innovation. Develop cutting-edge predictive models using various techniques, forecast trends, and craft financial impact modeling for changes in risk and utilization management. Communicate key results to executives and functional leads, supporting the underwriting team in developing pricing strategies.

Requirements

• Bachelor’s Degree or Master’s Degree in Statistics, Computer Science, Mathematics, Social Science, Finance, or a related field
• 10+ years’ experience as an actuary in medical or pharmacy benefits or healthcare payor analytics, including PBM, MA, or consulting
• Expertise in SQL, Python/R, ML libraries, and tools like SAS, PowerBI, or Tableau
• Demonstrated experience in building predictive models for drug spend and quality metrics, with complex claims/pharmacy datasets
• Experience in driving and taking ownership for creating cost savings and ROI models
• Strong communicator with ability to influence clinical, financial, and executive stakeholders
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable)

Responsibilities

• Lead development of cutting-edge predictive models using regression, ML, and simulation to forecast drug spend
• Develop ongoing short, mid, and long-range forecasts of rebates, trends, revenue, and expenses for Abarca and its clients
• Develop actuarial work products that inform business decision making
• Develop prescriptive frameworks that translate model insights into targeted interventions (e.g., outreach sequencing, formulary design, provider strategies)
• Craft financial impact modeling for changes in risk, utilization management, and trends
• Forecast trends using typical market indicators and Abarca innovative solutions. This can be done using any combination of methods (i.e., explanatory variables, simulation modeling, judgmental, and experience)
• Create models that showcase Abarca’s value proposition
• Assist in modeling the impact of new regulations and quality measures (i.e., STARs)
• Communicate key results to executives and functional leads
• Develop other financial models for critical priorities as needed
• Support the development of analytic models to empower the underwriting team when developing pricing strategies and financial guarantees for prospective clients
• Stay ahead of the curve on predictive analytics and payor trends to continuously refine tools and approaches
• You will have a pivotal role and be included in strategic leadership discussions and decisions

Preferred Qualifications

• Fellow or Associate in the Society of Actuaries (FSA or ASA)
• Experience with Commercial, Medicare, and Medicaid revenue methodologies as well as APMs and Value-Based Care contracts and creating value proposition models
• Experience as a professional actuary, including Medicare Advantage and Part D bidding trend and forecasting analytics
• Coding skills, preferably SAS, VBA, SQL, Python, and R