Harbor Health is hiring a Senior Actuary to serve as a key resource within our Actuarial team. You will lead the development, pricing, reserving, and financial forecasting for our individual product lines, requiring deep expertise in the ACA market and the ability to navigate its complex legal and strategic landscape.

What You'll Do

Develop, maintain, and refine actuarial pricing models for Individual/ACA and other health plan lines of business, including rate filings.
Analyze claims experience, utilization patterns, demographic trends, and market developments to inform pricing strategy.
Monitor and model the impact of federal and state legal and regulatory developments.
Establish and maintain IBNR reserve estimates and loss ratio projections.
Prepare monthly, quarterly, and annual actuarial accruals to support financial close processes.
Provide variance analysis comparing actual results to prior projections and communicate drivers to leadership.
Develop and lead risk adjustment accrual modeling and forecasting.
Support ACA risk score reconciliations and RADV audits.
Collaborate with Product and Benefit Design teams on benefit configuration, plan design analysis, and network adequacy modeling.
Provide actuarial support for market expansion decisions, product launches, and strategic initiatives.
Review public filings to understand competitor product and pricing strategies.
Develop scenario analyses and sensitivity testing to quantify financial risk and opportunity.
Present actuarial findings and recommendations clearly to non-actuarial audiences including Finance, Executive Leadership, and the Board.
Serve as a subject matter expert on Individual/ACA market dynamics, industry trends, and emerging actuarial methods.

What We're Looking For

5-10 years of actuarial experience in health insurance or managed care.
Demonstrated expertise in Individual/ACA lines of business, including ACA pricing, risk adjustment, and regulatory compliance.
Proficiency in actuarial and data analysis tools (Excel, SQL, Python, and other statistical and modeling software).