AVP of Actuarial Analysis

Job Description Summary

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The AVP of Actuarial Analysis will serve as Mosaic Health's senior actuarial leader, providing rigorous analytical direction across all three business entities. This executive-level role is central to the organization's financial strategy, risk management, and value-based care performance. Reporting to the CFO, the AVP will build and lead the actuarial function, translating complex healthcare data into actionable insights that support profitability, growth, and clinical program effectiveness.

This is a high-visibility role for a credentialed actuary who thrives in a fast-moving, multi-entity environment and brings both technical depth and executive presence.

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How will you make an impact & Requirements

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About Mosaic Health

Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health, including apree health, Millennium Physician Group, and CareMore Health, are multi-payer and serve nearly one million individuals across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations. For more information, visit www.mosaichealth.com.

Key Responsibilities

Actuarial Analysis & Modeling

• Design and lead actuarial models for medical cost analysis, trend forecasting, and risk stratification across MPG, CareMore, and apree health

• Conduct IBNR (Incurred But Not Reported) reserve analyses and claims development studies to support financial reporting and planning

• Build and maintain predictive models for healthcare utilization, disease prevalence, and population health risk

• Evaluate the financial performance of value-based care arrangements, capitation contracts, and shared savings programs

Financial Strategy & Enterprise Risk

• Partner with CFO and finance leadership to develop pricing strategies, rate filings, and financial projections

• Provide actuarial support for M&A due diligence, contract negotiations, and new market entry analyses

• Identify and quantify enterprise risk exposures; develop mitigation strategies and present findings to executive leadership

• Support actuarial assumptions embedded in budgets, long-range plans, and investor reporting

Value-Based Care & Payer Relationships

• Analyze performance against value-based contracts (ACO, MSSP, direct contracting) and quantify attribution, quality, and cost performance

• Develop cost and utilization benchmarks for payer negotiations across Medicare Advantage, Medicaid, and commercial lines of business

• Collaborate with clinical and population health teams to model the ROI of care management programs and interventions

• Translate actuarial findings into actionable recommendations for clinical and operational stakeholders

Leadership & Team Development

• Build, lead, and mentor a high-performing actuarial team; define roles, workflows, and development plans

• Establish actuarial best practices, governance frameworks, and documentation standards across all entities

• Serve as an internal subject matter expert; educate cross-functional partners on actuarial concepts and their business implications

• Present executive-level summaries, dashboards, and analyses to senior leadership and, as needed, to the Board

Qualifications

Required

• Fellowship in the Society of Actuaries (FSA) or Casualty Actuarial Society (FCAS); ASA with commensurate experience considered

• 10+ years of actuarial experience, with at least 5 years in healthcare (health plan, provider, or managed care setting)

• Deep expertise in medical cost analysis, reserve development, and value-based payment model analytics

• Proven experience in a multi-entity or multi-product environment with exposure to Medicare Advantage and/or Medicaid

• Strong proficiency in actuarial modeling tools (SAS, R, Python) and advanced Excel; experience with healthcare claims data warehouses

• Executive-level communication skills; able to synthesize complex analytical findings for non-technical audiences

Preferred

• Experience in a PE-backed, high-growth, or greenfield healthcare environment

• Exposure to physician group or IPA actuarial functions and risk-bearing provider organizations

• Familiarity with population health analytics platforms and risk adjustment methodologies (HCC, RAF scores)

• Experience presenting to C-suite executives, Boards, or investor groups

• Graduate degree in Actuarial Science, Mathematics, Statistics, or related field

Core Competencies

• Strategic Thinking: Connects actuarial insights to enterprise strategy and long-term financial planning.

• Analytical Rigor: Applies sound actuarial methodology with precision, transparency, and appropriate validation.

• Cross-Functional Partnership: Builds trusted relationships with finance, clinical, and operational teams across all entities.

• Executive Communication: Translates technical findings into compelling narratives for senior leadership and Board audiences.

• Team Leadership: Develops talent, sets high standards, and fosters a culture of intellectual rigor and accountability.

• Adaptability: Thrives in a high-growth, PE-backed environment with evolving priorities and tight timelines.

Work Environment & Physical Requirements

This position is primarily remote-eligible with periodic travel to Mosaic Health business locations. Employees must be able to remain stationary for extended periods, operate standard office technology, and communicate effectively in written and verbal formats. Reasonable accommodations may be made for individuals with disabilities.

Equal Employment Opportunity

Mosaic Health is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.