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Pricing Actuary

Medimpact Healthcare

Exemption Status: United States of America (Exempt) $132,323 - $186,576 - $240,828 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary The Principal, Pricing Outcomes & Economics is a leadership role responsible for enterprise-wide ownership of pricing outcomes across the PBM organization. This position serves as the primary economic integrator between Underwriting, Network Management, Trade Relations, Finance, Clinical, and Client Strategy, ensuring financial assumptions and pricing models are aligned throughout the PBM value chain. Essential Duties and Responsibilities Own the end-to-end pricing framework, and model management across Commercial, Medicare, Medicaid, Exchange, Cash, and Mail and Specialty lines of business. Establish enterprise pricing governance and decision-making processes. Lead development and enhancement of underwriting methodologies and pricing models. Align client pricing strategies with network reimbursement economics. Partner with Trade Relations to incorporate rebate and manufacturer economics into pricing strategies. Monitor pricing outcomes, profitability, spread performance, rebate realization, and margin attainment. Develop executive KPI dashboards and variance reporting. Assess financial impacts of regulatory and legislative changes. Lead cross-functional initiatives involving Underwriting, Network, Trade, Finance, Operations, and Sales. Drive profitability improvement, margin preservation, and pricing optimization opportunities. Other duties may be assigned. Supervisory Responsibilities No direct supervisory responsibilities. Will need to provide project leadership and direction to pricing, underwriting, economics, and analytics team members. Client Responsibilities This is an internal and external client/vendor facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client/vendor situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience BA/BS Degree; 8+ years related experience and 8+ years of SME in respective area(s); (or equivalent combination of education and experience). Computer Skills To perform this job successfully, an individual should have a solid knowledge of Microsoft Office Suite. Advanced knowledge of Excel will be required including Pivot tables, V-Lookup functions, and Data importing and exporting. Proficiency in SQL and knowledge of SAS are required. Experience with Access and database technology a plus. Certificates, Licenses, Registrations None required. Other Skills and Abilities Detail oriented and very organized. Ability to multitask and effectively switch between various tasks throughout the day. Excellent prioritization skills. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Mathematical Skills Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Language Skills Excellent communication skills. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Competencies Business Acumen Directing Others Organizational Agility Conflict Management Drive for Results Political Savvy Customer Focus Innovation Management Strategic Agility Decision Quality Managerial Courage Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Work Location Full time Remote location is acceptable. This position will require some on-site work at the San Diego Headquarters or other company location on occasion. Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. Working Hours This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm. Travel This position may require domestic travel of up to 25% of time. The Perks Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/Veterans OSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. MedImpact was founded more than three decades ago by a pharmacist and independent drug store owner who saw firsthand how families struggled with the high cost of prescriptions, and how it impacted their lives, financial security, and health. So, he started MedImpact to make prescription benefits understandable and accessible. While we have grown to be one of the leading PBMs in America, we remain as committed to these principles today as we did when it all began. #J-18808-Ljbffr

Vacancy posted 3 days ago
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