Actuarial Director, Pricing

Overview

This position provides leadership and actuarial direction for pricing and related services to support the organization’s financial and enrollment goals. Responsibilities include developing premium rates, preparing rate filings and bids, directing rating and pricing model development and maintenance, and supervising an actuarial team.

Responsibilities

• Direct all actuarial pricing and related services.
• Ensure accurate and reliable actuarial activities and sound actuarial analysis of risk.
• 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, vision, and supervision to a team of analysts, including:
  • Guiding team members on company policies, mandates, and workflow
  • Overseeing hiring, productivity, and quality of the team’s work
• Develop 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 aligned with organization income goals.
• 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 as needed for:
  • Calculation of applicable risk adjustment and risk sharing payables and receivables
  • Annual evaluation of premium deficiency reserve
  • Other required support for year-end statement of actuarial opinion
• Collaborate 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 actuarial students, credentialed actuaries, and non-actuarial analysts.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination.
  • Provide feedback, including 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 the development of department budgets.
• Coordinate business activities by maintaining collaborative partnerships with Underwriting, Product Development, Sales, and Finance.
• Actively 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, including working with other departments to improve interdepartmental processes.
  • Promote utilization of lean methodologies for continuous improvement within 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 regarding 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.

Education, Certificates, Licenses

• 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.

Knowledge & Abilities

• Demonstrated ability to perform job functions with responsibility and in a manner that promotes confidence in performance.
• 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 improvement cycle.
• Creative and innovative approach to responding to challenges.
• Ability to apply actuarial methods and modeling techniques.
• Ability to verify and document assumptions; justify analysis and recommendations with sound logic and actuarial principles; and adhere to Actuarial Standards of Practice.

Skills

• Accountable leadership
• Business & financial acumen
• Data-driven & analytical
• Decision making
• Empowerment
• Influential communications
• Situational leadership
• Strategic planning

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

Location & Work Environment

• 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.
• Ability to read and comprehend both written and spoken English.
• Communicate clearly and effectively.

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.

Other Information

• Equal opportunity employer: All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, including race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information, or age.
• Employment is at-will at all times.
• This job description reflects 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 required.