VP & Chief Actuary
Job Summary:
The VP, Chief Actuary, leads a high-performing team of approximately 70 associates, serving as the principal actuarial advisor to the EVP, CFO & Treasurer and executive leadership. This role oversees all actuarial functions for Independence Health Group (IHG), including pricing, reserving, forecasting, and medical cost analytics across Commercial and Medicare Advantage products. The Chief Actuary ensures actuarial soundness, regulatory compliance, and financial sustainability, while driving innovation and market competitiveness. The position maintains direct accountability to state insurance departments for actuarial opinions and rate filings and plays a key leadership role in enterprise strategy and growth initiatives.
Key Responsibilities:
· Pricing and Pharmacy Underwriting
o Direct and oversee pricing activity and rate filings for Commercial and Medicare market segments including the establishment of pricing and product strategies, formulas and tools for use by the Sales and Underwriting teams
o Oversee the Pharmacy Underwriting team collaborating closely with sales, and pharmacy teams
o Partner with the P&L, Sales and other leadership on the achievement of growth and profitability goals
o Provide regular progress updates to the CFO, Segment leaders and other executives
· Medical and Pharmacy Cost and Trend Analytics
o Oversee evaluation of claim cost trends and establish medical cost assumptions for use in pricing and forecasting
o Support provider contracting and related value-based contracting initiatives to position the enterprise competitively and achieve medical cost management targets.
o Develop and continue to enhance consistent ways to analyze drivers of cost trends and measure the impact of programs. Explain differences between forecasts and actual results for both medical and pharmacy spend. These methods should support health value optimization (HVO) efforts, ensuring they fit in with other medical cost initiatives and self-funded client strategies
o Provide oversight of pharmacy economics: drug trend forecasting, specialty pipeline modeling, PBM performance, and value-based pharmacy arrangements
· Claim Reserving and Appointed Actuary
o Establish methodologies and processes to accurately estimate claim reserve liabilities for all products and lines
o Serve as or oversight of the Appointed Actuary, providing actuarial opinions for required regulatory filings
o Support internal/external auditors, insurance departments, Finance and others in validating and documenting reserves or other actuarial interrogatories
· Planning and Strategy
o Support the development of premium, revenue and claim cost estimates for the annual operating plan, mid-year forecast updates and long-term strategic planning, partnering with FP&A and providing strategic insight on projections and variance evaluation
· Regulatory Compliance
o Ensure regulatory compliance and analytics across all segments with technical leadership where appropriate for submissions and inquiry responses
· Data, Analytics and Model Governance
o Modernize actuarial modeling capabilities (predictive analytics, machine learning, actuarial automation) partnering with Business Technology Solutions and Informatics on cloud enablement and model lifecycle management
o Establish governance standards for actuarial data quality and model documentation, ensuring compliance with internal controls, audit and regulatory expectations
· Strategic Growth
o Provide actuarial leadership for organic/inorganic growth and strategic provider partnerships (e.g. Tandigm), conducting due diligence and financial impact modeling
· Leadership and Talent Development
o Champion professional development, mentoring, training and succession planning including sponsoring the actuarial student program and rotations
o Uphold high ethical standards and foster a culture of accountability, collaboration and innovation
Qualifications
· Bachelor’s degree in Mathematics, Actuarial Science and/or Risk Management
· Fellow of the Society of Actuaries (FSA), Member of the American Academy of Actuaries (MAAA)
· Eligibility to serve as Appointed Actuary under applicable state requirements
· 15+ years of progressively responsible Actuarial experience
· 10+ years management and leadership experience within Actuarial functions, including leading multi-disciplinary teams
· Strong health insurance background; knowledge of health care delivery systems a plus
· Working knowledge of health insurance regulatory requirements, the Affordable Care Act, and accounting principles are a plus
· Excellent verbal and written communication skills with strong executive presence and credibility with executive leadership and the Board
· Demonstrated mastery across commercial and Medicare Advantage pricing, filings and revenue mechanics
· Proven experience leading claim reserving and deep familiarity with NAIC and state DOI expectations
· Advanced proficiency in actuarial modeling and analytics with experience in pharmacy economics including Part D, commercial PBM arrangements, and specialty trend dynamics
· Strategic thinking with the ability to translate complex actuarial insights into actionable executive decisions
· Talent engagement, development and succession planning for large teams with a small population of full remote resources
· A highly ethical and trustworthy leader. A leadership style based on relationship and team building, trust, influence, credibility and service, together with a willingness to mentor, develop and educate
· Cross functional influence with internal partners in Finance, Underwriting, Sales, Clinical, Provider Contracting, Operations, IT and Legal
Independence has implemented a “Hybrid” model which provides our associates with the ability work in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.