Actuarial Director, Pricing

Job not on LinkedIn

🔥 2 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $127.3k - $216.5k / year

⏰ Full Time

🔴 Lead

📊 Actuary

👻 Ghost score 0%

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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 actuarial pricing and related services • Develop premium rates for Commercial business and Medicare Advantage bids • Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and required statements of opinion • Direct development, implementation, and maintenance of rating and pricing models • Coordinate with departments to ensure regulatory compliance and consistency with rating and underwriting policies • 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 terminations • Maintain collaborative partnerships with Underwriting, Product Development, Sales, and Finance • Participate in strategic and internal committees • Support Medicare Advantage and Commercial P&L owners with financial loss-ratio initiatives • Drive process improvement and use of lean methodologies • Participate in PacificSource research activities • Follow privacy policy and HIPAA requirements and perform other assigned duties

🎯 Requirements

• At least six years actuarial experience • 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 • Active member in good standing of American Academy of Actuaries • Knowledge of actuarial methods and modeling techniques • Ability to verify and document assumptions and justify analysis with sound logic and actuarial principles • Adherence to Actuarial Standards of Practice • Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines • Ability to identify problems, design and implement solutions, and monitor results • Ability to read and comprehend 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/carry files and business materials

🏖️ Benefits

• Work from home (WFH) arrangement • Travel approximately 5% of the time • Equal opportunity employment • Diversity, equity, inclusion and social justice efforts • General office equipment ergonomically configured