Actuary

Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

We are seeking an experienced Actuary (ASA or FSA) to lead our Affordable Care Act (ACA) Risk Adjustment analytic and forecasting functions. This role is ideal for an actuary who combines deep technical expertise with strong business acumen, and who can translate complex risk adjustment mechanics into clear, actionable insights for finance department.

You will own key components of our ACA commercial individual and small group analytics-driving risk score modeling, transfer payment projections, competitive intelligence, and strategic recommendations that directly influence pricing, product strategy, and financial performance.

Key Accountabilities

• Lead development, maintenance, and enhancement of ACA Risk Adjustment projection models, including risk score forecasts, transfer payment estimates, and competitive benchmarking.
• Analyze population morbidity, risk score drivers, hierarchical condition categories (HCCs), and model factors to identify trends and business implications.
• Partner with actuarial pricing to evaluate plan performance.
• Monitor regulatory updates; assess financial and operational impacts and communicate findings effectively.
• Develop dashboards, reporting tools, and executive-ready summaries that clearly convey emerging trends and strategic recommendations.

Required Qualifications

• ASA or FSA designation from the Society of Actuaries (SOA).
• Minimum 5 years (FSA) or 10 years (ASA) of actuarial experience, with at least 2 years working directly with ACA Risk Adjustment or ACA pricing.
• Strong proficiency with SQL or SAS; ability to work with large, complex datasets.
• Deep understanding of ACA market dynamics, competitive landscape, and regulatory environment.
• Excellent communication skills, with the ability to explain technical results for non-technical audiences.
• Strong problem-solving ability, attention to detail, and sense of ownership.

Required Certifications/Licensure

• FSA/ASA Achieved

Preferred Qualification

• Familiarity with actuarial pricing for ACA individual or small group markets.
• Experience with cloud-based data environments such as Snowflake.
• Leadership or management experience is a plus.

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, Madison, WI, Omaha, NE, or St. Louis, MO.

The full salary grade for this position is $100,300 - $172,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $100,300 - $150,465. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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For further information, please review the Know Your Rights notice from the Department of Labor.