Commercial Pricing Actuary
About The Position
The Commercial Pricing Actuary is a critical actuarial leader responsible for directing strategy, modeling, and financial execution for Commercial lines of business, including Group and Self-Funded/ASO. The role requires expertise in Commercial rating mechanics, rating model architecture, underwriting strategy, and state regulatory rate filings. It also emphasizes operational execution: building pricing infrastructure, meeting regulatory submission deadlines, standardizing rating cycles, and collaborating with underwriting, sales, finance, network contracting, and state regulators. The role develops and maintains scalable rating models and pricing engines, shapes product and benefit pricing strategy, and establishes pricing assumptions. It partners with underwriting on group pricing, ASO and stop-loss methodologies, and portfolio risk analysis. It also directs Commercial rate filings and rate reviews, interfaces with state regulators, oversees relevant ACA financial mechanics, and presents rate strategies and impacts to executive and business stakeholders. Devoted Health is a healthcare company founded in 2017 with a mission to improve the health and well-being of older Americans. Its integrated care platform combines data and AI with clinical and service experiences. The company describes its workplace as valuing diversity, collaboration, change, and advancement.
Requirements
- At least 8 years of progressive healthcare actuarial experience, including at least 5 years focused directly on Commercial actuarial pricing, rating model development, and regulatory rate filings.
- Demonstrated experience building rating engines from scratch or significantly upgrading pricing tools.
- Proficiency in actuarial modeling and data manipulation, such as SQL, Python, R, or SAS.
- Direct experience managing the full lifecycle of Commercial rate filings through SERFF and navigating state regulatory reviews to secure timely approvals.
- Hands-on experience partnering with or establishing guidelines for underwriting teams, experience rating logic, and portfolio performance tracking.
- Demonstrated ability to complete complex, time-sensitive filings and pricing projects on schedule and manage high-stakes regulatory deadlines.
- Exceptional interpersonal and collaborative skills, including the ability to explain complex actuarial concepts as clear strategic choices for non-actuarial partners.
Nice To Haves
- ASA or FSA designation and MAAA membership; equivalent practical mastery and pricing leadership experience will also be considered.
- Experience interfacing with reserving, value-based contracting, or medical economics functions.
- Comfort working in a fast-paced, high-growth environment where rating tools and processes are continuously developed and optimized.
Responsibilities
- Build, refine, and maintain scalable actuarial rating models and pricing engines for Commercial Large Group lines of business.
- Partner with product, clinical, and market leadership to price benefit packages and evaluate product trade-offs, cost-sharing mechanics, and benefit changes against profitability targets.
- Establish, defend, and document pricing assumptions, including manual rates, age/gender and area factors, trend projections, administrative expense allocations, and margin targets.
- Contribute actuarial oversight to underwriting policy, risk selection, complex quote requests, experience rating formulas, and credibility logic.
- Design and maintain pricing methodologies for ASO products, employer-specific fee structures, and stop-loss/reinsurance coverage options.
- Monitor group risk profiles, employer renewal performance, and adverse selection, and apply insights to rate development and underwriting guidelines.
- Direct preparation, documentation, and filing of annual and quarterly Commercial rate filings across state insurance departments and regulatory bodies.
- Serve as the primary actuarial interface with state regulators during rate reviews and respond to objections, inquiries, and public comments to secure approvals.
- Oversee pricing mechanics related to ACA risk adjustment, MLR rebate calculations, state rate cap mandates, and the No Surprises Act.
- Collaborate with Finance, Healthcare Economics, Sales/Distribution, Network Management, and Clinical Operations to align rating assumptions with operations, distribution goals, and provider contracting terms.
- Prepare executive-level presentations on rate filing strategies, portfolio rate impacts, and margin projections for leadership, board members, and business partners.
- Drive complex, time-sensitive filings and pricing projects to completion on schedule.
Benefits
- Employer-sponsored health, dental, and vision plans with low or no premium.
- Generous paid time off.
- $100 monthly mobile or internet stipend.
- Stock options for all employees.
- Bonus eligibility for roles below Director; commission eligibility for Sales roles.
- Parental leave program.
- 401(k) program.
- Additional rewards and benefits may be available.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
