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Clover Health

Medicare Advantage insurer with personalized care

Chief Actuary

Actuarial & Risk ModellingConfirmed live in the last 24 hours
Full-timeRemote in USA$274k - $356k

About the Job

Requirements

  • Be a Fellow of the Society of Actuaries (FSA) and a Member of the American Academy of Actuaries.
  • Have significant leadership experience in Medicare Advantage actuarial functions, including pricing, reserving, forecasting, and bid development.
  • Have demonstrated experience deploying AI workflows across functional areas and enthusiasm for applying automation and modern tooling to improve the actuarial function.
  • Have experience leading large, cross-functional initiatives that influence executive decision-making.
  • Be able to discuss actuarial methodology with technical experts and communicate business implications to executives and non-technical stakeholders.
  • Have a track record of building, mentoring, and developing high-performing actuarial teams.

Responsibilities

  • Lead Clover's enterprise actuarial function, including pricing, forecasting, reserving, medical economics, Part D, Stars analytics, and bid strategy.
  • Establish the long-term vision for actuarial and modernize the function through AI, automation, and scalable analytical infrastructure.
  • Build AI-enabled workflows that reduce manual effort, accelerate insight generation, and improve actuarial decision-making while ensuring explainability, governance, and regulatory compliance.
  • Lead the annual Medicare Advantage bid strategy and pricing process, framing tradeoffs among growth, competitiveness, margin, risk, and capital requirements to support enterprise planning and executive decision-making.
  • Assume responsibility for actuarial opinions, reserve adequacy, and related regulatory actuarial requirements, including transitioning responsibilities currently supported by external actuarial partners.
  • Guide reserving methodology, IBNR development, forecasting, and emerging experience analysis to provide timely, reliable financial insights.
  • Partner with Finance leadership to strengthen forecasting, planning, capital management, and enterprise performance measurement.
  • Collaborate with Medical Economics to identify healthcare cost trends, evaluate interventions, and develop strategies that improve member outcomes while managing medical expense.
  • Drive adoption of modern analytics tools and AI capabilities across the actuarial organization, helping the team operate faster, smarter, and with greater transparency.
  • Serve as a trusted advisor to executive leadership, translating complex actuarial concepts into clear business recommendations.
  • Lead, develop, and scale a high-performing actuarial organization, including organizational design, performance management, workforce capacity, and development of actuarial and analytical talent.
  • Build strong partnerships across Finance, Clinical, Operations, Growth, Data Science, and Engineering to ensure actuarial insights are embedded in strategic decision-making.
  • Establish and maintain actuarial governance, model review, documentation, control, and validation standards that support regulatory compliance, financial integrity, and sound executive decision-making.
  • Build trusted relationships across Finance and key business partners.
  • Assess the current actuarial organization, tools, and operating model.
  • Develop a roadmap for AI adoption and workflow automation across the actuarial function.
  • Gain deep familiarity with Clover's pricing, forecasting, reserving, and medical economics processes.
  • Begin implementing AI-enabled actuarial workflows that improve efficiency and insight generation.
  • Strengthen forecasting, reserving, and bid processes through improved automation and cross-functional collaboration.
  • Successfully assume ownership of additional actuarial responsibilities, including reserve oversight and governance.
  • Establish a clear long-term organizational vision for the actuarial function.
  • Build a modern actuarial organization by combining actuarial science with AI-enabled decision support.
  • Improve forecasting accuracy, operational efficiency, and enterprise decision-making through advanced analytics and automation.
  • Develop a highly engaged, high-performing actuarial team recognized as a strategic partner across the organization.

About the Company

Clover Health

Medicare Advantage insurer with personalized care

Clover Health provides Medicare Advantage plans for seniors in the United States, offering coverage that goes beyond traditional Medicare. Its services include personalized care, fitness memberships, home checkups, drug coverage, and Medigap insurance, with revenue coming from member premiums and Medicare reimbursements. The product works by enrolling members in Medicare Advantage and delivering added benefits through a network of healthcare providers and fitness centers, plus home visits and proactive support to manage health. The company differentiates itself with a focus on tailored, attentive care and a growing provider network to enhance member benefits, aiming to improve health outcomes. Its primary goal is to help seniors stay healthier and reduce out-of-pocket costs by combining comprehensive coverage with personalized services.

Company size
501-1,000
Company stage
IPO
Headquarters
Nashville, TN
Founded
2014

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