Lead Actuary – Pharmacy Pricing - REMOTE

Prime Therapeutics•Home, WV

3d•Remote

About The Position

The Lead Actuary – Pharmacy Pricing leads complex pharmacy pricing and rebate guarantee analyses for Prime’s existing and prospective clients. This role partners closely with senior leaders to deliver client-specific pricing recommendations, navigate market-driven uncertainty, and translate complex analyses into clear, actionable insights. The position leads high-visibility initiatives and mentors actuarial team members.

Requirements

Bachelor’s degree in Math, Actuarial Science, Economics or Finance
8 years of actuarial work experience to include 6 years in a healthcare organization or PBM
Actuarial designation (ASA or FSA)
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Advanced proficiency in Excel; working knowledge of SAS, SQL, VBA, or similar tools
Strong analytical and problem-solving skills with the ability to work through ambiguity
Ability to manage multiple complex priorities and deliver under tight timelines
Clear, professional written and verbal communication skills
Effective client-facing and executive presentation skills

Nice To Haves

Experience pricing Commercial, Medicare, and/or Medicaid pharmacy benefits
Demonstrated experience leading complex pricing or rebate-related initiatives
Prior client-facing experience supporting executive-level discussions

Responsibilities

Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership
Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models
Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results
Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling
Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence
Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability
Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback
Monitor health policy, regulatory, and market developments and assess implications for pricing strategy
Ensure compliance with applicable federal regulations and actuarial standards
Perform other duties as assigned