Actuarial Director, Pricing

🕒 October 17

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $127.3k - $216.5k / year

⏰ Full Time

🔴 Lead

📊 Actuary

👻 Ghost score 20%

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PacificSource Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Direct all actuarial pricing and related services • Ensure accurate and reliable actuarial activities and sound actuarial analysis of risk • Develop premium rates for the Commercial line of business and Medicare Advantage Bids • Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion • Direct development, implementation, and maintenance of Commercial rating and pricing models • Support reserving, forecasting, budgeting, risk adjustment, risk sharing, premium deficiency reserve, and year-end actuarial opinion processes • Direct analysis of risk, cost, and utilization with the Actuarial Director of Health Economics • Lead and supervise actuarial students, credentialed actuaries, and non-actuarial analysts • Assist with hiring, staff development, coaching, performance reviews, corrective actions, and employee termination • Maintain collaborative partnerships with Underwriting, Product Development, Sales, and Finance • Participate in strategic and internal committees • Support Medicare Advantage and Commercial P&L owners on financial loss ratio initiatives • Lead process improvement and promote lean methodologies • Participate in PacificSource research activities • Follow privacy policy and HIPAA laws and regulations • Perform other duties as assigned

🎯 Requirements

• At least six years actuarial experience required • Three years management experience required • 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 • 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 • 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 • Ability to read and comprehend both written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive motions, and lift and carry files and business materials

🏖️ Benefits

• Equal opportunity employment • Work inside a general office setting with ergonomically configured equipment • Travel required approximately 5% of the time • Employment remains AT-WILL at all times

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