Senior Actuary, Pricing & Underwriting

Job Description

Job Description

Description:

ABOUT TRUDATARX

TruDataRx, Inc. uses objective clinical data to help clients improve the clinical efficacy and reduce the costs of pharmacy benefits for its members. We are independent from all players in the pharmaceutical manufacturing and distribution industries, enabling us to best serve our clients. We value the following characteristics in our team members:

• Outward Mindset – foundation of our culture, which influences the right behaviors, that leads to results
• Entrepreneurial – the ability to get things done with resources you don’t control
• Humility – deep comfort in knowing when you don’t know and asking questions
• Collaboration – we always give benefit of doubt that each person has something to contribute

POSITION SUMMARY

We are seeking a Senior Actuary with 5+ years of dedicated experience in the pharmacy benefits space. In this role, you will be the quantitative engine behind our pharmacy pricing, trend forecasting, and formulary strategies.

You will work closely with our clinical, underwriting, and product teams to develop cutting edge models of the financial impact of formulary management on pharmacy benefits for self-insured employers. As a senior member of the team, you will not only build complex financial models but also translate technical findings into actionable business strategies for leadership.

ESSENTIAL FUNCTIONS

• Pricing & Underwriting: Develop, maintain, and enhance pricing models for pharmacy benefit programs, including AWP discounts, MAC pricing, dispensing fees, and rebate guarantees. Key member of sales team, supporting RFPs and proposal creation.
• Trend Analysis & Forecasting: Monitor and forecast pharmacy cost and utilization trends for clients. Specifically analyze the financial impact of high-cost specialty medications, biosimilar market entries, and shifting utilization patterns.
• Formulary & Rebate Modeling: Partner with clinical pharmacy teams to model the financial impact of formulary changes, clinical utilization management (prior authorizations, step therapy), and pharmaceutical manufacturer rebate contracts. Lead strategic initiatives related to technology and data, as well as emerging market topics like Cell and Gene therapies.
• Financial Reporting & Reserving: Support month-end and quarter-end financial reporting, including the calculation of pharmacy-specific liabilities, rebate receivables, and IBNR (Incurred But Not Reported) reserves. Lead design, development, and deployment of client reporting, PG reconciliation, and internal performance reporting.
• Strategic Advising: Serve as a subject matter expert on pharmacy economics for internal stakeholders and external clients. Translate complex actuarial data into clear, concise narratives for executive leadership. Provide consultation to clients and internal partners and participates in contract negotiation and review.
• Mentorship: Guide and review the work of junior analysts, fostering a culture of technical rigor and continuous learning.
• Other duties as required.*

*This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Requirements:

REQUIREMENTS

• Education: Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field.
• Credentials: Associate of the Society of Actuaries (ASA) designation required; Member of the American Academy of Actuaries (MAAA).
• Experience: 5+ years of relevant actuarial experience, with a minimum of 3 years specifically focused on pharmacy benefits, PBM (Pharmacy Benefit Manager) pricing.
• Technical Proficiency: Advanced skills in Excel and proven experience manipulating large, complex healthcare datasets using SQL, SAS, Python, or R.
• Domain Expertise: Deep understanding of pharmacy pricing mechanics (AWP, WAC, MAC), drug pipeline impacts, rebate aggregators, and specialty pharmacy economics.

Company Standard Requirements:

• Ability to work well with others in a collaborative environment
• Ability to get things done with resources you don’t control
• Willingness to admit you don’t know and ask for help
• Exhibit constant curiosity and a drive to problem solve
• Exhibit desire to learn and grow on a continuous basis