Director, Underwriting and Actuarial

Job not on LinkedIn

3 days ago

🐻 Alaska – Remote

Although this job is listed in Alaska, this company may be open to hiring remote in other states.

🌺 Hawaii – Remote

Although this job is listed in Hawaii, this company may be open to hiring remote in other states.

+11 more states

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌾 North Dakota – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $129k - $170k / year

⏰ Full Time

🔴 Lead

📊 Actuary

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Navitus Health Solutions

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Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

1001 - 5000 employees

Founded 2003

⚕️ Healthcare Insurance

💊 Pharmaceuticals

🤝 B2B

📋 Description

• Serves as a primary point of contact for clients that utilize Navitus’ actuarial services for pharmacy benefits cost forecasting and management. • Participates in new business development activity with prospective clients as the lead subject matter expert for actuarial services offered by Navitus. • Provides oversight, guidance, and models to facilitate the actuarial analysis needed to develop financial projections for alternative plan designs. • Supports Finance projections of long-term revenues and profitability by LOB and client. • Provides oversight, guidance, and models to analyze population and other changes to determine the impact on projected costs for a book of business. • Understands drug trends, new drug pipelines, patent expirations, and other factors to guide best estimate thinking around projected trend. • Contributes to the analytics strategy for the organization, working with leaders in Analytics, Sales Financial Support, and Underwriting. • Leads development efforts of Navitus Health Solutions pricing and risk models. • Ensures that those responsible for managing care and cost outcomes have the clinical and financial data needed to inform the development of strategies designed to manage care and cost outcomes for defined populations. • Establishes actuarial policies and standards that ensure effective controls and compliance with all applicable statutory, regulatory, professional, and corporate standards and regulations. • Develops, leads, and guides the actuarial function for the organization, ensuring that the team meets client needs and that expenses are managed within budget. • Participates in, adheres to and supports compliance, people and culture, and learning programs. • Performs other duties as assigned.

🎯 Requirements

• Education: Bachelor’s degree in Mathematics, Statistics, Actuarial Science, or a related field required. • Certification/Licenses: Associate of the Society of Actuaries required. Fellowship preferred. • Experience: 5+ years of progressive actuarial experience (preferably in Health Insurance, pharmacy benefits management, or comparable capacity) required. • Experience in more than 2 functions (pricing, reserving, modeling, reporting and analysis) required. • 5+ years of underwriting experience in a Pharmacy Benefit Management, Managed Care, or adjacent setting. • Experience across multiple product offerings including Medicare, Medicaid, Commercially Insured, and Administrative Service only products required. • 5 years of leadership experience managing people and work product for an actuarial team required. • Experience in influencing leaders at a variety of levels and build consensus required.

🏖️ Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!