Actuarial Director, Pricing

Overview

This role directs all actuarial pricing and related services. The position is responsible for accurate and reliable actuarial activities, sound actuarial analysis of risk, and supporting attainment of organizational financial and enrollment goals. The role also provides leadership and vision to a team of analysts.

Responsibilities

• Develop the organization’s premium rates for the Commercial line of business and Medicare Advantage bids through regular and systematic actuarial analysis that is:
  • Actuarially sound
  • Competitive in the marketplace
  • Aligned with income objectives and organization goals
• Prepare required rate filings/bids and supporting exhibits, including signing actuarial certifications, memoranda, and required statements of opinion
• Direct the development, implementation, and maintenance of rating and pricing models for the Commercial line of business, coordinating with other departments to ensure regulatory compliance and consistency with rating and underwriting policies
• Support reserving, forecasting, and budgeting processes as needed for the calculation of applicable risk adjustment and risk sharing payables and receivables, annual evaluation of premium deficiency reserve, and other required support for year-end statement of actuarial opinion
• Partner with the Actuarial Director of Health Economics to direct analysis of elements of risk, cost, and utilization, ensuring alignment of pricing assumptions and enterprise cost management activities
• Provide leadership and supervision to a team of actuarial students, credentialed actuaries, and non-actuarial analysts
• Guide the team on company policies, mandates, and workflow
• Oversee hiring, productivity, and quality of the team’s work, including:
  • Hiring and staff development
  • Coaching and performance reviews
  • Corrective actions and termination decisions
  • Providing regular one-on-ones and performance evaluations for direct reports
• Stay informed about changes to actuarial curriculum and requirements; propose updates to the student program as needed
• Assist in development of department budgets
• Coordinate business activities by maintaining collaborative partnerships with key departments including Underwriting, Product Development, Sales, and Finance
• Participate in strategic and internal committees to disseminate information within the organization and represent organizational philosophy
• Support Medicare Advantage and Commercial P&L owners with input into operational and strategic initiatives related to financial loss ratio goals
• Drive process improvement by working with other departments to improve interdepartmental processes; promote utilization of lean methodologies for continuous improvement
• Participate in the design and execution of research activities performed within the organization

Supporting Responsibilities

• Meet department and company performance and attendance expectations
• Follow the organization’s privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
• Perform other duties as assigned

Requirements

• At least six years actuarial experience
• At least three years management experience
• Health experience preferred
• Baccalaureate degree in mathematics, statistics, actuarial science, or a related field
• Enrolled as Fellow in Society of Actuaries
• Active member in good standing of American Academy of Actuaries
• Demonstrated knowledge to perform job functions with accuracy under pressure, prioritize tasks, 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 analysis and recommendations using sound logic and actuarial principles, and adhere to Actuarial Standards of Practice
• Ability to read and comprehend both written and spoken English; communicate clearly and effectively

Preferred Qualifications

• Health experience

Compensation & Benefits

• Base range: $127,338.01 - $216,474.62

Compensation disclaimer: The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. The stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Location

• General office setting with ergonomically configured equipment
• Travel required approximately 5% of the time

Physical Requirements

• Stoop and bend
• Sit and/or stand for extended periods of time while performing core job functions
• Repetitive motions including typing, sorting, and filing
• Light lifting and carrying of files and business materials

Additional Information

• Employment is at-will at all times.
• This job description indicates the general nature and level of work performed and is subject to change; it is not intended to be a comprehensive list of all duties, responsibilities, and qualifications.