Actuarial Director, Pricing

Overview

This role directs all actuarial pricing and related services to ensure accurate, reliable actuarial activities. Responsibilities include ensuring sound actuarial analysis of risk to support the organization’s financial and enrollment goals, and providing leadership and vision to a team of analysts.

Responsibilities

• Direct actuarial pricing and related services to ensure accurate and reliable actuarial activities.
• Ensure sound actuarial analysis of risk to support attainment of financial and enrollment goals.
• Work to increase enrollment and maintain a strong financial position.
• Provide documented input on decisions that impact the risk assumed through current or proposed activities.
• Manage and provide leadership and vision to a team of analysts, including guidance on company policies, mandates, and workflow.
• Oversee hiring, productivity, and quality of the team’s work.

Essential Responsibilities

• Develop the organization’s premium rates for the Commercial line of business and Medicare Advantage Bids through regular and systematic analysis that is actuarially sound, competitive in the marketplace, and aligns with organization income goals and objectives.
• Prepare required rate filings/bids and supporting exhibits, including signing actuarial certifications, memoranda, and required statements of opinion.
• Direct development, implementation, and maintenance of rating and pricing models for the Commercial line of business.
• Coordinate with other departments to ensure compliance with regulatory requirements and consistency with rating and underwriting policies.
• Support reserving, forecasting, and budgeting processes 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.
• Work with the Actuarial Director of Health Economics to direct analysis of various 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.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees; provide feedback through regular one-on-ones and performance evaluations for direct reports.
• Stay informed regarding changes to actuarial curriculum and requirements; propose updates to the student program as needed.
• Assist in the development of department budgets.
• Coordinate business activities by maintaining collaborative partnerships with 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 by providing input into operational and strategic initiatives related to financial loss ratio goals.
• Lead process improvement efforts and work with other departments to improve interdepartmental processes; promote utilization of lean methodologies for continuous improvement throughout the department.
• 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, and active member in good standing of American Academy of Actuaries.
• Must possess the knowledge and assume responsibility for performing job functions in a manner that promotes confidence in abilities.
• Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines.
• Ability to identify and define problems, design and implement solutions, and monitor results in a continuous cycle.
• Creative and innovative approach to responding to challenges.
• Ability to apply actuarial methods and modeling techniques.
• Verifies and documents assumptions; justifies analysis and recommendations using sound logic and actuarial principles.
• Adheres to Actuarial Standards of Practice.
• Ability to read and comprehend both written and spoken English and communicate clearly and effectively.

Preferred Qualifications

• Health experience.

Competencies

• Building Trust
• Building a Successful Team
• Aligning Performance for Success
• Building Customer Loyalty
• Building Strategic Work Relationships
• Continuous Improvement
• Decision Making
• Facilitating Change
• Leveraging Diversity
• Driving for Results

Compensation & Benefits

Base Range: $127,338.01 - $216,474.62

Compensation disclaimer: The wage range reflects the full range for this position. The maximum amount listed represents the highest possible salary and should not be interpreted as a typical starting wage. Actual compensation will be determined based on 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

• Work inside in a general office setting with ergonomically configured equipment.
• Travel is 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

• This job description indicates the general nature and level of work performed by employees within this position and is subject to change.
• It is not designed to be a comprehensive list of all duties, responsibilities, and qualifications required.
• Employment remains AT-WILL at all times.