Senior Network Pricing Actuary

Senior Network Pricing Actuary

The Senior Network Pricing Actuary is part of the growing Network Pricing team, which partners with the national and local market Provider Contracting teams to ensure our contract negotiations, network strategy, and understanding of our network performance are informed by reliable data and modeling. This role serves as the regional lead, responsible for work including: coordinating and presenting analyses to influence our negotiation strategy for major deals; coordinating and performing modeling to support major negotiations; facilitating market network performance management forums, bringing insights into network performance drivers and opportunities, and driving accountability; and partnering with the provider contracting and delivery system teams to develop the network strategy. This is a leadership level role that will engage regularly with the VPs of provider contracting, the market CFOs, and the regional health plan SVP. While not having any direct reports, this role will partner closely with the network pricing analysts in the team, delegating analysis and providing guidance and coaching. The work will require knowledge and experience of provider contracting, network strategy, and how they impact unit cost trends and product & network financial performance.

Essential Responsibilities:

• Practices self-leadership and promotes learning in others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; communicating information and providing advice to drive projects forward; adapting to competing demands and new responsibilities; providing feedback to others, including upward feedback to leadership; influencing, mentoring, and coaching team members; fostering open dialogue amongst team members; evaluating and responding to the strengths and weaknesses of self and unit members; and adapting to and learning from change, difficulties, and feedback.
• Drives the execution of multiple work streams by identifying customer and operational needs; developing and updating new procedures and policies; gaining cross-functional support for objectives and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring progress; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; solving highly complex issues; and influencing the completion of project tasks by others.
• Leads actuarial documentation and reporting by coordinating the completion of the actuarial portion of financial reports and tax returns, and responses to insurance regulations; and presenting results internally and externally to senior leadership.
• Leads product line evaluations by coordinating analysis of product line financials, pricing, reserve, valuation, cash flow analysis, and product investment strategy; and making recommendations based on product line performance, risk, and assumptions used in product development.
• Furthers actuarial research by identifying the needs and implementing complex methods to advance the actuarial techniques, standards, assumptions, and the legal and regulatory environment.
• Monitors financial risks and opportunities by developing advanced and non-traditional actuarial methods; and leveraging industry knowledge to conduct and determine actuarial analyses.
• Influences senior business partners by translating complex actuarial constructs into actionable recommendations; and initiating actuarial and financial advice in compliance with the Actuarial Standards of Practice.
• Identifies needs and provides guidance on how to build framework and assumptions for new, existing, and non-traditional actuarial models to meet business needs.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Analytical Skills
• Client Focus
• Debugging and Troubleshooting
• Demonstrating Personal Flexibility
• Economics
• Getting Work Done Through Others
• Initiative
• Maintain Files and Records
• Managing Diverse Relationships
• Mathematics
• Negotiation
• Organizational Skills
• Project Management
• Statistical Programming Language
• Stress Tolerance
• Technical Communication
• Trust

Minimum Qualifications:

• Bachelors degree in mathematics or related field AND Minimum ten (10) years actuarial experience. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.
• Associate of the Society of Actuaries Certificate OR Associate of the Casualty Actuarial Society Certificate

Preferred Qualifications:

• Four (4) years experience in a leadership role with or without direct reports.
• Six (6) years experience with databases and spreadsheets.

Primary Location: California, Pasadena, Walnut Center - Regional Offices

Additional Locations:

• Portland, OR
• Oakland, CA
• Atlanta, GA
• Rockville, MD
• Aurora, CO
• San Diego, CA
• Rosemont, CA
• Renton, WA

Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Flexible Employee Status: Regular Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Po/Ho Corp - MOC HealthPlan Analytics - 0308 Pay Range: $175600 - $227150 / year