Actuarial Director, Pricing
About The Position
Directs PacificSource’s actuarial pricing and related services, ensuring accurate and reliable actuarial activities and sound analysis of risk in support of the organization’s financial and enrollment goals. The role works to increase enrollment and maintain a strong financial position, provides documented input on decisions affecting assumed risk, and leads a team of analysts. Responsibilities include guidance on company policies, mandates, and workflow, as well as oversight of hiring, productivity, and work quality. The position develops premium rates for the Commercial line of business and Medicare Advantage bids; prepares rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion; and directs the development and maintenance of pricing models. It also supports reserving, forecasting, budgeting, risk adjustment, and year-end actuarial opinion work. The role collaborates across departments and with the Actuarial Director of Health Economics, supports P&L owners, participates in committees and research, and leads process improvement. The position provides leadership and supervision to actuarial students, credentialed actuaries, and non-actuarial analysts, including staff development, coaching, performance reviews, and related employment actions. Work is performed indoors in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Requirements
- At least six years of actuarial experience.
- At least three years of management experience.
- Baccalaureate degree in mathematics, statistics, actuarial science, or a related field.
- Enrolled as a Fellow in the Society of Actuaries.
- Active member in good standing of the American Academy of Actuaries.
- Ability to apply actuarial methods and modeling techniques.
- Ability to verify and document assumptions, support analysis and recommendations with sound logic and actuarial principles, and adhere to Actuarial Standards of Practice.
- Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines.
- Ability to identify and define problems, design and implement solutions, and monitor results in a continuous cycle.
- Ability to respond creatively and innovatively to challenges.
- Ability to read and comprehend written and spoken English and communicate clearly and effectively.
- Ability to perform the stated physical activities, including stooping and bending, sitting or standing for extended periods, repetitive motions, and light lifting and carrying.
Nice To Haves
- Health experience.
Responsibilities
- Develop actuarially sound, competitive premium rates for the Commercial line of business and Medicare Advantage bids, consistent with organizational income goals and objectives.
- Prepare required rate filings and bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion.
- Direct the development, implementation, and maintenance of Commercial rating and pricing models, coordinating with other departments on regulatory compliance and consistency with rating and underwriting policies.
- Support reserving, forecasting, and budgeting, including risk adjustment and risk-sharing payables and receivables, premium deficiency reserve evaluation, and year-end statement of actuarial opinion support.
- Work with the Actuarial Director of Health Economics to direct analysis of risk, cost, and utilization and align pricing assumptions with enterprise cost management activities.
- Lead and supervise actuarial students, credentialed actuaries, and non-actuarial analysts.
- Assist with hiring, staff development, coaching, performance reviews, corrective actions, and employee termination; provide regular feedback and performance evaluations to direct reports.
- Stay informed about changes to actuarial curriculum and requirements and propose updates to the student program as needed.
- Assist in developing department budgets.
- Coordinate business activities and maintain collaborative partnerships with Underwriting, Product Development, Sales, and Finance.
- Participate in strategic and internal committees, sharing information and representing company philosophy.
- Support Medicare Advantage and Commercial P&L owners with input on operational and strategic initiatives related to company financial loss ratio goals.
- Lead process improvement and work with other departments to improve interdepartmental processes; promote lean methodologies and continuous improvement.
- Participate in the design and execution of research activities performed within PacificSource.
- Meet department and company performance and attendance expectations.
- Follow PacificSource privacy policies and HIPAA requirements concerning the confidentiality and security of protected health information.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Director
