Actuarial Director, Pricing
About The Position
Direct PacificSource’s actuarial pricing and related services, ensuring accurate and reliable actuarial work and sound analysis of risk that supports the organization’s financial and enrollment goals. The role develops premium rates for the Commercial line of business and Medicare Advantage bids, oversees pricing models and regulatory filings, and provides input on decisions affecting assumed risk. It also supports reserving, forecasting, budgeting, risk adjustment, and year-end actuarial opinion processes. The position provides leadership and supervision to a team of actuarial students, credentialed actuaries, and non-actuarial analysts, including hiring, staff development, coaching, performance reviews, and oversight of team productivity and work quality. It collaborates with departments such as Underwriting, Product Development, Sales, Finance, and Health Economics, and supports Commercial and Medicare Advantage P&L owners. The role also participates in strategic committees, process improvement, and research activities. The work is performed inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Physical activities include stooping and bending, sitting and/or standing for extended periods, repetitive motions such as typing, sorting, and filing, and light lifting and carrying of files and business materials.
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.
- Enrollment as an Associate or Fellow in the Society of Actuaries.
- Active membership in good standing with the American Academy of Actuaries.
- Ability to apply actuarial methods and modeling techniques.
- Ability to verify and document assumptions, justify analysis and recommendations using sound logic and actuarial principles, and adhere to Actuarial Standards of Practice.
- Ability to complete tasks accurately under pressure, determine priorities, and meet deadlines.
- Ability to identify and define problems, design and implement solutions, and monitor results as part of continuous improvement.
- 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 motions including typing, sorting, and filing; and lift and carry files and business materials weighing light amounts.
- Travel approximately 5% of the time.
Nice To Haves
- Health experience.
- Skills in accountable leadership, business and financial acumen, data-driven analysis, decision making, empowerment, influential communications, situational leadership, and strategic planning.
Responsibilities
- Develop Commercial premium rates and Medicare Advantage bids through regular, systematic analysis that is actuarially sound, competitive, and aligned with organizational goals.
- Prepare required rate filings and bids and supporting exhibits; sign actuarial certifications, memoranda, and required statements of opinion.
- Direct the development, implementation, and maintenance of Commercial rating and pricing models, coordinating with other departments to meet regulatory requirements and maintain consistency with rating and underwriting policies.
- Support reserving, forecasting, and budgeting processes, including risk adjustment and risk-sharing payables and receivables, premium deficiency reserve evaluations, 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 one-on-ones to direct reports.
- Stay informed about 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, disseminate information, and represent company philosophy.
- Support Medicare Advantage and Commercial P&L owners by providing input on operational and strategic initiatives related to company financial loss-ratio goals.
- Improve processes across the department and with other departments, and promote the use of lean methodologies for continuous improvement.
- Participate in designing and executing research activities within PacificSource.
- Meet department and company performance and attendance expectations.
- Follow PacificSource privacy policy and HIPAA laws and regulations concerning 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
