Actuarial Director, Pricing

PacificSource•Bend, OR

15h

About The Position

Directs PacificSource’s actuarial pricing and related services, ensuring accurate and reliable actuarial activities and sound analysis of risk. The role supports the organization’s financial and enrollment goals by helping increase enrollment, maintain a strong financial position, and provide documented input on decisions affecting assumed risk. It provides leadership and vision for a team of analysts, including guidance on company policies, mandates, and workflow, and oversight of hiring, productivity, and work quality. The position develops Commercial premium rates and Medicare Advantage bids; prepares rate filings, bids, supporting exhibits, and actuarial certifications and opinions; and directs the development and maintenance of Commercial rating and pricing models. It supports reserving, forecasting, budgeting, risk adjustment, premium deficiency reserve evaluations, and year-end actuarial opinions. The role works across departments and with health economics, product, underwriting, sales, and finance stakeholders to align pricing assumptions, manage costs, support financial and strategic goals, and improve processes. It also leads staff development and performance management, participates in research and committees, and promotes continuous improvement. The work is performed inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. The role requires compliance with PacificSource privacy policies and HIPAA requirements. Compensation range: $127,338.01–$216,474.62.

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 Fellow in the Society of Actuaries.
Active member in good standing of the American Academy of Actuaries.
Ability to perform actuarial job functions accurately and responsibly and promote confidence in one’s abilities.
Ability to accomplish tasks accurately under pressure, prioritize, and meet deadlines.
Ability to identify and define problems, design and implement solutions, and monitor results in a continuous improvement cycle.
Ability to apply actuarial methods and modeling techniques.
Ability to verify and document assumptions, justify analyses and recommendations using sound logic and actuarial principles, and adhere to Actuarial Standards of Practice.
Ability to read and comprehend written and spoken English and communicate clearly and effectively.
Ability to stoop and bend; sit and/or stand for extended periods; perform repetitive typing, sorting, and filing; and lift and carry files and business materials weighing light amounts.

Nice To Haves

Health experience preferred.

Responsibilities

Develop Commercial premium rates and Medicare Advantage bids through regular, systematic analysis that is actuarially sound, competitive, and aligned with organizational income goals.
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 calculations for risk adjustment and risk-sharing payables and receivables, annual premium deficiency reserve evaluation, and year-end 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, development, coaching, performance reviews, corrective actions, and termination.
Provide regular feedback, one-on-ones, and performance evaluations to direct reports; stay informed about actuarial curriculum and requirements and propose student-program updates as needed.
Assist with development of department budgets.
Maintain collaborative partnerships with Underwriting, Product Development, Sales, Finance, and other key departments to coordinate business activities.
Participate in strategic and internal committees, share information across the organization, and represent company philosophy.
Support Medicare Advantage and Commercial P&L owners with input on operational and strategic initiatives related to company financial loss-ratio goals.
Improve processes across the department and with other departments, and promote lean methodologies for continuous improvement.
Participate in the design and execution of research activities within PacificSource.
Meet department and company performance and attendance expectations; follow privacy policy and HIPAA requirements for confidentiality and security of protected health information; perform other duties as assigned.