Actuarial Director, Pricing

Overview

This role directs actuarial pricing and related services to support accurate, reliable actuarial work, sound risk analysis, and achievement of financial and enrollment goals. Responsibilities include developing premium rates, preparing rate filings and bids, leading and supervising an actuarial team, and coordinating with cross-functional partners to ensure compliance and consistency.

Responsibilities

• Direct actuarial pricing and related services, ensuring accurate and reliable actuarial activities.
• Conduct sound actuarial analysis of risk to support organizational financial and enrollment goals.
• Provide documented input to decisions that impact the risk assumed through current or proposed activities.
• Increase enrollment and maintain a strong financial position.
• 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 consistent with organization goals and objectives.
• Prepare required rate filings/bids and supporting exhibits, including signing actuarial certifications, memoranda, and required statements of opinion.
• Lead 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 needed for calculation of applicable risk adjustment and risk sharing payables and receivables, annual evaluation of premium deficiency reserve, and other required year-end support for the statement of actuarial opinion.
• Partner with the Actuarial Director of Health Economics to direct analysis of elements of risk, cost, and utilization; ensure 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 team members on company policies, mandates, and workflow.
• Oversee hiring, productivity, and work quality.
• Assist with staff development, coaching, performance reviews, corrective actions, and termination of employees, 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 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.
• Provide input to Medicare Advantage and Commercial P&L owners on operational and strategic initiatives related to the company’s financial loss ratio goals.
• Drive process improvement and interdepartmental improvements; work to promote utilization of lean methodologies for continuous improvement.
• Participate in the design and execution of research activities.

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 (6) years actuarial experience.
• At least three (3) years management experience.
• 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.
• 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.
• Ability to apply actuarial methods and modeling techniques.
• Verifies and documents assumptions, justifies analysis and recommendations with sound logic and actuarial principles, and adheres to Actuarial Standards of Practice.
• Ability to read and comprehend both written and spoken English; 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 for the role and should not be interpreted as a typical starting wage. Actual compensation is determined based on factors such as qualifications, experience, education, and internal equity. The stated range is for informational purposes only and does not guarantee any specific salary within that range.

Location

• 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.

Equal Opportunity / Other Notes

• Equal opportunity employer. All qualified applicants receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information, or age.

Disclaimer

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.