Lead Actuary – Pharmacy Pricing - REMOTE

Prime Therapeutics; Columbus (OH); Remote; USD 124,000 - 211,000; Full time

Job summary

Prime Therapeutics leads complex pharmacy pricing analyses and rebate guarantee work for clients, partnering with senior leadership to translate results into actionable pricing guidance.

The Lead Actuary – Pharmacy Pricing role focuses on developing pricing analyses, forecasting rebate performance, and mentoring actuarial staff while monitoring policy changes that impact pricing strategy. This remote role offers national scope and significant client interaction.

Qualifications

• Bachelor’s degree in Math, Actuarial Science, Economics or Finance or equivalent; HS diploma or GED is required.
• 8 years actuarial work experience to include 6 years in a healthcare organization or PBM.
• Actuarial designation (ASA or FSA).
• Must be eligible to work in the United States without the need for work visa or residency sponsorship.
• Advanced proficiency in Excel; working knowledge of SAS, SQL, VBA, or similar tools.
• Strong analytical and problem-solving skills with the ability to work through ambiguity.
• Ability to manage multiple complex priorities and deliver under tight timelines.
• Clear, professional written and verbal communication skills; effective client-facing and executive presentation skills.

Responsibilities

• Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership.
• Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models.
• Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results.
• Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling.
• Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence.
• Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability.
• Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback.
• Monitor health policy, regulatory, and market developments and assess implications for pricing strategy.
• Ensure compliance with applicable federal regulations and actuarial standards.
• Perform other duties as assigned

Education

Bachelor’s degree in Math, Actuarial Science, Economics or Finance or equivalent

Tools

SAS

SQL

VBA

Job description

Full time

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Lead Actuary – Pharmacy Pricing - REMOTE

Job Description

The Lead Actuary – Pharmacy Pricing leads complex pharmacy pricing and rebate guarantee analyses for Prime’s existing and prospective clients. This role partners closely with senior leaders to deliver client-specific pricing recommendations, navigate market-driven uncertainty, and translate complex analyses into clear, actionable insights. The position leads high-visibility initiatives and mentors actuarial team members.

Key Responsibilities

• Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership
• Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models
• Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results
• Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling
• Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence
• Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability
• Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback
• Monitor health policy, regulatory, and market developments and assess implications for pricing strategy
• Ensure compliance with applicable federal regulations and actuarial standards
• Perform other duties as assigned

Minimum Qualifications

• Bachelor’s degree in Math, Actuarial Science, Economics or Finance or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 8 years of actuarial work experience to include 6 years in a healthcare organization or PBM
• Actuarial designation (ASA or FSA)
• Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Advanced proficiency in Excel; working knowledge of SAS, SQL, VBA, or similar tools
• Strong analytical and problem-solving skills with the ability to work through ambiguity
• Ability to manage multiple complex priorities and deliver under tight timelines
• Clear, professional written and verbal communication skills
• Effective client-facing and executive presentation skills

Preferred Qualifications

• Experience pricing Commercial, Medicare, and/or Medicaid pharmacy benefits
• Demonstrated experience leading complex pricing or rebate-related initiatives
• Prior client-facing experience supporting executive-level discussions

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

Positions will be posted for a minimum of five consecutive workdays.

At Prime Therapeutics (Prime), we are a different kind of PBM. We’re reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference.

We know that people make all the difference. If you’re ready for a purpose-driven career and are passionate about simplifying health care, let’s build the future of pharmacy together.

Prime Therapeutics LLCis proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Prime Therapeutics LLCis proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.