Actuarial Director, Pricing

pacificsource; North Carolina; Hybrid; USD 150,000 - 230,000; Full time

Job summary

PacificSource is seeking a senior actuarial leader to direct pricing and related services, ensuring compliant, competitive rate filings and robust pricing models. You will guide a team of actuaries and analysts, oversee hiring and staff development, and partner with underwriting, product development, sales, and finance.

Ideal candidates have extensive actuarial experience, management background, and Fellow status in the actuarial profession.

Qualifications

• At least six years actuarial experience and three years management experience required.
• Health experience preferred.
• Baccalaureate degree in mathematics, statistics, actuarial science, or a related field.

Responsibilities

• Develop premium rates for Commercial and Medicare Advantage bids.
• Prepare rate filings, bind actuarial certifications and opinions.
• Direct development, implementation, and maintenance of pricing models for Commercial line.
• Support reserving, forecasting and budgeting for risk adjustments and year-end actuarial statements.
• Collaborate with Actuarial Director to align pricing assumptions with cost management.
• Provide leadership to a team of actuaries and analysts.
• Assist with hiring, coaching, and performance reviews.
• Coordinate with Underwriting, Product Development, Sales, and Finance.
• Participate in strategic and internal committees to disseminate information and align with company philosophy.
• Support Medicare Advantage and Commercial P&L owners with financial goals.
• Promote lean methodologies for continuous improvement within the department.
• Participate in research activities.

Skills

Actuarial pricing

Leadership

Forecasting

Pricing models

Team management

Education

Baccalaureate degree in mathematics, statistics, actuarial science, or a related field

Fellow of the Society of Actuaries (FSA) enrolled and member of the American Academy of Actuaries

Job description

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will 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. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Direct all actuarial pricing and related services. Responsible for accurate and reliable actuarial activities. Ensure sound actuarial analysis of risk, resulting in the attainment of PacificSource's financial and enrollment goals. Work to increase enrollment and maintain a strong financial position. Provide documented input on decisions which impact the risk assumed through various current or proposed activities. Manage and provide leadership and vision to team of analysts. Provide guidance to team members regarding company policies, mandates, and workflow. Oversee hiring, productivity, and quality of the team's work.

Essential Responsibilities:

• Responsible for developing the organization's premium rates for the Commercial line of business and Medicare Advantage Bids through regular and systematic analysis in a manner that is actuarially sound, competitive in the marketplace, and provides income in accordance with organization goals and objectives.
• Prepare required rate filings/bids and supporting exhibits, signing actuarial certifications, memoranda and required statements of opinion.
• Direct the development, implementation, and maintenance of rating and pricing models for the Commercial line of business, coordinating with other departments to ensure compliance with regulatory requirements and consistency with PacificSource rating and underwriting policies.
• Support reserving, forecasting and budgeting processes as needed for the calculation of applicable risk adjustment and risk sharing payables and receivables, annual evaluation of premium deficiency reserve, and other required support for year-end statement of actuarial opinion.
• Work with the Actuarial Director of Health Economics to direct the analysis of various elements of risk, cost, and utilization, and 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.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
• Stay informed regarding changes to actuarial curriculum and requirements. Propose updates to student program as needed.
• Assist in the development of department budgets.
• Coordinate business activities by maintaining collaborative partnerships with key departments including Underwriting, Product Development, Sales, and Finance.
• Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
• Support Medicare Advantage and Commercial P&L owners by providing input into operational and strategic initiatives as they relate to the financial loss ratio goals of the company.
• Responsible for process improvement and working with other departments to improve interdepartmental processes. Work with staff to promote utilization of lean methodologies for continuous improvement throughout the department.
• Participate in the design and execution of research activities performed within PacificSource.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Work Experience:

At least six years actuarial experience and three years management experience required. Health experience preferred.

Education, Certificates, Licenses:

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.

Knowledge:

Must possess the knowledge and assume responsibility for performing the functions of the job position. Must perform and be responsible for the functions in a manner which promotes confidence in the person's abilities. Ability to accomplish tasks accurately under pressure, determine priorities, and to meet deadlines. Ability to identify an