Pharmacy Actuary

Lockton • Kansas City, MO

10d

About The Position

The Pharmacy Actuary serves as the primary actuarial subject matter expert bridging pharmacy benefit strategy, strategic pricing, vendor procurement, and actuarial projections. The role translates pharmacy RFP assumptions, vendor proposals, rebate arrangements, formulary strategies, and emerging pharmacy trends into financial assumptions that support strategic pricing and client financial projections. It partners closely with Pharmacy and Health Actuarial teams to ensure pricing strategies and cost projections reflect contractual terms, market dynamics, and strategic initiatives.

The role also provides actuarial analysis and consulting on pharmacy-specific topics and programs, including Medicare Part D and the 340B Drug Pricing Program. It develops and enhances pharmacy methodologies, models, tools, and reporting, and communicates projection results and financial concepts to technical and nontechnical stakeholders. Documentation, governance, and compliance with actuarial standards and regulatory requirements are part of the position.

Requirements

• Associate of the Society of Actuaries (ASA) designation.
• At least five years of actuarial or financial analytics experience within a pharmacy benefit manager (PBM).
• Demonstrated knowledge of PBM pricing, contracts, guarantees, rebate arrangements, formulary strategies, and pharmacy benefit procurement.
• Strong understanding of pharmacy utilization and trends, specialty pharmaceuticals, pipeline therapies, and relevant regulatory and market developments.
• Experience developing or overseeing actuarial models, forecasting tools, financial analyses, and management reporting.
• Strong analytical and problem-solving skills, including assessing assumptions, quantifying financial impacts, and evaluating risk and opportunity.
• Ability to translate complex contractual and pharmacy concepts into clear actuarial assumptions, financial projections, and business recommendations for technical and nontechnical audiences.
• Strong cross-functional collaboration skills and ability to work effectively with Pharmacy, Health Actuarial, analytics, consulting, procurement, and vendor teams.
• Proficiency with relevant actuarial, data analysis, modeling, and reporting tools.

Nice To Haves

• Fellow of the Society of Actuaries (FSA) designation.

Responsibilities

• Serve as the primary actuarial liaison between Pharmacy and Health Actuarial teams, ensuring pharmacy strategies, contractual arrangements, legislative impacts, and market dynamics are reflected in cost projections.
• Partner with Pharmacy Analytics to support PBM procurement, vendor evaluations, and contract negotiations by modeling proposals, guarantees, pricing methodologies, rebate arrangements, formulary strategies, and contractual provisions.
• Translate modeling results into actuarial assumptions and financial projections; evaluate performance and variances against contract terms; and apply insights to future projections and negotiations.
• Validate vendor financial projections and assess risks, opportunities, and key assumption sensitivity.
• Evaluate utilization, pharmacy trends, specialty drug impacts, pipeline therapies, regulatory changes, market developments, and emerging solutions to improve projections and inform strategic planning.
• Develop and enhance pharmacy-specific methodologies, models, tools, and reporting, including actuarial projections, PBM contract analyses, and population health studies, aligned with overall health benefits strategy and projections.
• Provide actuarial analysis and consulting on pharmacy-specific topics and programs, including Medicare Part D and the 340B Drug Pricing Program.
• Communicate complex pharmacy financial concepts, methodologies, and projection results to technical and nontechnical stakeholders.
• Maintain documentation of pharmacy methodologies, assumptions, tools, and projection frameworks, and ensure compliance with actuarial standards, regulatory requirements, and internal governance processes.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed