Actuarial Principal - PBM Consulting

Oliver James; Chicago (IL); Remote; USD 200,000 - 275,000; Full time

Job summary

An established industry player seeks an Actuarial Principal for a remote role in PBM Consulting. In this pivotal position, you will collaborate with senior consultants and leaders, providing strategic guidance to optimize client solutions in the healthcare sector. Your expertise will be key in managing client relationships, overseeing project delivery, and conducting peer reviews. This role offers a unique opportunity to engage with diverse clients, including insurance carriers and healthcare systems, while driving business development initiatives. If you're a self-motivated professional with a passion for healthcare consulting, this is the perfect chance to elevate your career.

Qualifications

• 7+ years of experience in PBM or healthcare consulting; actuarial training preferred.
• Strong understanding of pharmacy topics and financial structures.

Responsibilities

• Lead execution teams and manage client relationships.
• Conduct RFP evaluations for pharmacy benefit vendors.

Skills

PBM operating model expertise

Healthcare consulting experience

Analytical skills

Communication skills

Problem-solving skills

Knowledge of healthcare delivery models

Actuarial credentials (ASA, FSA)

Education

Bachelor's degree

Job description

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Job Details

Title: Actuarial Principal - PBM Consulting

Location: Remote

Type: FTE

Salary: $200,000-$275,000

Note: Only those who do not require current or future sponsorship can be considered, no 3rd parties.

Role Overview

As a Principal, you will collaborate with leaders and senior consultants from a global strategy and analytics firm. You will work on diverse client solutions, with high interaction and visibility with clients, including insurance carriers and healthcare systems. Your responsibilities include business development, leading execution teams, managing client relationships, overseeing project delivery, and conducting peer reviews.

Potential Projects

1. Conducting RFP evaluations for pharmacy benefit vendors (PBMs, GPOs, etc.) on behalf of health plans
2. Managing pharmacy contract market checks
3. Validating rebate and discount guarantees based on PBM agreements
4. Advising on and negotiating PBM contract language
5. Providing strategic guidance to optimize rebate structures and discounts

Requirements & Skills

• Bachelor's degree
• Expertise in the PBM operating model and healthcare industries
• Minimum 7 years of experience in PBM or healthcare consulting; actuarial training preferred
• Knowledge of healthcare delivery models: Commercial, Medicaid, Medicare, Individual Marketplace
• Understanding of pharmacy topics like GPOs, 340B, NADAC pricing, pharmacy network contracting, PBM financial structures
• Actuarial credentials (ASA, FSA) preferred
• Strong communication, organizational, analytical, and problem-solving skills
• Self-motivated, adaptable, and team-oriented

Application Process

Apply online or email your updated resume to Brandon Cook at [e-mail].

Additional Info

• Seniority level: Not Applicable
• Employment type: Full-time
• Job function: Consulting, IT, Sales
• Industry: Staffing and Recruiting

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