Director, EGWP Actuary

The posting, as Judi Health wrote it

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health .

Location: Hybrid (Local to Denver, NYC, or Charlotte area)

Position Summary

The Director, EGWP Actuary directs the strategy, governance, and operations of the EGWP actuarial function and serves as the accountable actuarial leader for the EGWP line of business. Reporting to the VP, Actuarial & Underwriting, this role holds a high degree of independence to formulate and administer actuarial policies and programs, make decisions regarding strategic direction, operational management, and budget, and oversee Medicare Part D pricing, bids, reserving, and monthly close. The Director builds and leads the EGWP actuarial team through subordinate managers and senior actuarial professionals, with full authority for hiring, performance management, promotions, and exits, and holds accountability for significant human and financial resources. Partnering with senior and executive leaders across sales, underwriting, EGWP, PBM, and finance, the Director translates business segment strategy into functional plans, makes final decisions on implementation, and is accountable for results that affect the financial performance of the line of business and the broader organization. This role requires deep actuarial expertise , strong business and financial acumen, and the ability to influence executive decision-making.

Position Responsibilities

• Direct the development, maintenance, and ongoing enhancement of Medicare Part D financial models, including settlements, forecasting, and experience monitoring, through the actuarial team.
• Set and approve the actuarial strategy and governance for EGWP bids, including assumptions, pricing recommendations, risk thresholds, and profitability targets, with final decision-making authority on implementation.
• Partner with the VP, Actuarial & Underwriting and senior leadership to establish strategic plans and objectives for the EGWP line of business, translate business segment strategy into functional plans, and contribute to the development of organizational policies.
• Own and approve the actuarial components of the monthly close process, including

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managers or senior professionals and managing a departmental budget.

• Expert level experience in developing pricing as it relates to Part D EGWP. Understanding of the nuances and strategic importance of how each decision affects the overall bid.
• In-depth knowledge of CMS bid processes, risk adjustment methodologies, and regulatory requirements.
• Excellent communication and influencing skills, with a track record of presenting to and advising executive leadership.
• A proactive and adaptable mindset, with the ability to thrive in an evolving and entrepreneurial environment.
• Associate of the Society of Actuaries or Fellow of the Society of Actuaries

Preferred Qualifications

Prior EGWP experience

• Experience building or scaling an actuarial function in a growing or entrepreneurial organization.
• Programming (SQL, SAS, Python, R) experience.

New York, NY Salary Range
$187,600 — $234,500 USD

Denver, CO Salary Range
$172,000 — $215,000 USD

Charlotte, NC Salary Range
$156,400 — $195,500 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy .