Actuarial Consultant – Commercial Pharmacy

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RxBenefits, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1995

⚕️ Healthcare Insurance

💳 Fintech

🤝 B2B

💰 Private Equity Round on 2020-12

Healthcare Insurance • Fintech • B2B

RxBenefits, Inc. is a company that specializes in providing innovative pharmacy benefits solutions to employers and their employees. They focus on optimizing the management of prescription drug plans to reduce costs and improve health outcomes. Through advanced analytics and personalized member support, RxBenefits aims to transform the pharmacy benefits experience for their clients.

📋 Description

• Proactively provides resources, information, advice, and expertise with coworkers and stakeholders; influencing others through technical explanations and examples • Completes work assignments by applying up-to-date expertise within the Commercial Pharmacy benefit to generate creative solutions; ensuring all procedures and policies are followed; leveraging an understanding of data, and resources to support projects or initiatives; collaborating cross-functionally to solve business problems; identifying and monitoring priorities, deadlines, and expectations; communicating progress and information; identifying, recommending, and implementing ways to address improvement opportunities; and escalating issues or risks as appropriate. • Supports actuarial documentation by preparing and reviewing for accuracy and reasonability the actuarial portion of financial reports and responses to audits, client/broker inquiries and insurance regulations • Participates in product line evaluations by conducting analysis of product line financials, pricing, and valuation analysis; and analyzing product line performance, risk, and assumptions used in product / RFP development. • Stays abreast of actuarial research by examining developments in standards, assumptions, competition, and the legal and regulatory environment. • Assesses, analyzes and interprets financial risks and opportunities by applying actuarial methods; and conducting actuarial analyses. • Supports collaborations with business partners by understanding the business needs; translating actuarial constructs into non-technical recommendations; and complying with the Actuarial Standards of Practice. • Supports actuarial modeling by developing and enhancing actuarial models; assisting with the development of alternative assumptions and forecasts using in-house models or actuarial software; and assisting with validating the data and results.

🎯 Requirements

• 5+ years of Commercial Payer / PBM experience required • 5+ years actuarial experience • Expert in pharmacy data analytics. • Ability to apply data visualization for project tasks, such as frequency distributions, pareto charts, analysis of variance, and correlation techniques. (Advanced Excel required) • Mastery of data manipulation software such as Excel, SAS, Python • Excellent communication and relational skills required for interaction with internal and external customers and end users at all levels • Ability to translate business needs into technical specifications and user models • Strong time management skills, demonstrate ability to manage multiple, parallel assignments with accountability for timely, cost-effective results • The ability to function and manage projects independently • Proficient in process mapping, root cause analysis, and quality/process improvement methodologies • Bachelor’s degree in Actuarial Science required • Proficient SQL / SAS preferred • FSA, ASA, MAAA certifications strongly preferred

🏖️ Benefits

• Remote first work environment • Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members • Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision) • Additional buy-up options for Short- and Long-Term Disability and Life Insurance • 401(k) with an employer match up to 3.5% available after 60 days • Community Service Day to give back and support what you love in your community • 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like • Reimbursements for high-speed internet, we’ll send you a computer and monitors to help you do your best work • Tuition Reimbursement for accredited degree programs • Paid New Parent Leave that can be used for adoption or birth • Pet insurance to protect your furbabies • A robust mental health benefit and EAP service through Spring Health to support you when you need it most