Actuarial Director (Pharmacy)

BlueCross BlueShield of South Carolina•Columbia, SC

8d•Onsite

About The Position

Responsible for strategy execution and operational direction of actuarial efforts for assigned line of business. Description Location: This position is full-time Monday-Friday in a typical office environment. This role is located onsite at 4101 Percival Road, Columbia, SC 29229. Position Purpose: Lead the execution of strategy and provide operational direction for actuarial initiatives within the Pharmacy line of business. Drive development of models, pricing strategies, and risk assessments to support organizational objectives and influence key business decisions. What You'll Do: Directs and provides leadership support for line of business by setting and guiding actuarial initiatives. Ensures compliance with regulatory requirements and actuarial standards. Designs and prepares actuarial reports. Conducts risk assessments needed to meet financial objectives. Develops pricing for new benefits, models financial impacts of alternative rating arrangements, and prepares the corporate financial plan and multi-year forecast. Responsible for hiring and maintaining staff, which includes interviewing and selection of personnel, completing performance reviews, counseling staff, and other administrative matters. Develops professional staff by identifying and coordinating training needs. Performs other special projects and AD HOC analyses as requested. This role will be dedicated to Pharmacy, so the preferred experience is someone who has worked in this area and has the necessary expertise to: Provide actuarial support for pharmacy initiatives and RFPs. Collaborate effectively with LOB leadership, managed care teams, PBM actuaries, and other vendors. Deliver actionable insights that improve financial performance and forecasting capabilities. This role will also be responsible for estimating and reporting rebates and will need to build the necessary relationships with the PBMs, Pharmacy Contracting, and Finance to achieve this.

Requirements

Bachelor's degree in actuarial science, Mathematics, Statistics or another related field.
7 Years Actuarial experience.
2 years supervisory or managerial experience OR equivalent military experience in grade E4 or above.
Extensive knowledge of insurance products, operations, and existing regulations.
Awareness of legal, political, economic, and environmental impacts on the insurance product and operation.
Organizational skills.
Good judgment.
Ability to persuade, negotiate or influence.
Strong verbal and written communication skills including presentation skills.
Microsoft Office.
Working knowledge of mainframes.
Computer programming skills.
Fellow of the Casualty Actuarial Society or the Society of Actuaries or An Associate of the Society of Actuaries (ASA) or Associate of the Casualty Actuarial Society (ACAS) with at least 9 years of experience.

Nice To Haves

8 Years-Actuarial experience.
2 years of supervisory or managerial experience OR equivalent military experience in grade E4 or above.
Customer service skills.
Ability to explain technical subjects to a non-technical audience.
Fellow of the Society of Actuaries (FSA) or Fellow of the Casualty Actuarial Society (FCAS) and Member of the Academy of Actuaries (MAAA)
Knowledge of Access or other database software.
Working knowledge of DB2 database.
Computer systems support knowledge.

Responsibilities

Directs and provides leadership support for line of business by setting and guiding actuarial initiatives.
Ensures compliance with regulatory requirements and actuarial standards.
Designs and prepares actuarial reports.
Conducts risk assessments needed to meet financial objectives.
Develops pricing for new benefits, models financial impacts of alternative rating arrangements, and prepares the corporate financial plan and multi-year forecast.
Responsible for hiring and maintaining staff, which includes interviewing and selection of personnel, completing performance reviews, counseling staff, and other administrative matters.
Develops professional staff by identifying and coordinating training needs.
Performs other special projects and AD HOC analyses as requested.
Provide actuarial support for pharmacy initiatives and RFPs.
Collaborate effectively with LOB leadership, managed care teams, PBM actuaries, and other vendors.
Deliver actionable insights that improve financial performance and forecasting capabilities.
Estimating and reporting rebates and will need to build the necessary relationships with the PBMs, Pharmacy Contracting, and Finance to achieve this.