Actuarial Director, Pricing

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Direct all actuarial pricing and related services. Responsible for accurate and reliable actuarial activities. Ensure sound actuarial analysis of risk, resulting in the attainment of PacificSource's financial and enrollment goals. Work to increase enrollment and maintain a strong financial position. Provide documented input on decisions which impact the risk assumed through various current or proposed activities. Manage and provide leadership and vision to team of analysts. Provide guidance to team members regarding company policies, mandates, and workflow. Oversee hiring, productivity, and quality of the team’s work.

Essential Responsibilities:

• Responsible for developing the organization's premium rates for the Commercial line of business and Medicare Advantage Bids through regular and systematic analysis in a manner that is actuarially sound, competitive in the marketplace, and provides income in accordance with organization goals and objectives.
• Prepare required rate filings/bids and supporting exhibits, signing actuarial certifications, memoranda and required statements of opinion.
• Direct the development, implementation, and maintenance of rating and pricing models for the Commercial line of business, coordinating with other departments to ensure compliance with regulatory requirements and consistency with PacificSource rating and underwriting policies.
• Support reserving, forecasting and budgeting processes as needed for the calculation of applicable risk adjustment and risk sharing payables and receivables, annual evaluation of premium deficiency reserve, and other required support for year-end statement of actuarial opinion.
• Work with the Actuarial Director of Health Economics to direct the analysis of various elements of risk, cost, and utilization, and ensure alignment of pricing assumptions and enterprise cost management activities.
• Provide leadership and supervision to a team of actuarial students, credentialed actuaries, and non-actuarial analysts.
• Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
• Stay informed regarding changes to actuarial curriculum and requirements. Propose updates to student program as needed.
• Assist in the development of department budgets.
• Coordinate business activities by maintaining collaborative partnerships with key departments including Underwriting, Product Development, Sales, and Finance.
• Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
• Support Medicare Advantage and Commercial P&L owners by providing input into operational and strategic initiatives as they relate to the financial loss ratio goals of the company.
• Responsible for process improvement and working with other departments to improve interdepartmental processes. Work with staff to promote utilization of lean methodologies for continuous improvement throughout the department.
• Participate in the design and execution of research activities performed within PacificSource.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

Work Experience: At least six years actuarial experience and three years management experience required. Health experience preferred.

Education, Certificates, Licenses: Baccalaureate degree in mathematics, statistics, actuarial science, or a related field. Enrolled as Fellow in Society of Actuaries, and active member in good standing of American Academy of Actuaries.

Knowledge: Must possess the knowledge and assume responsibility for performing the functions of the job position. Must perform and be responsible for the functions in a manner which promotes confidence in the person's abilities. Ability to accomplish tasks accurately under pressure, determine priorities, and to meet deadlines. Ability to identify and define problems, design and then implement solutions, and further monitor results, in a continuous cycle. Is creative and innovative in responding to challenges. Ability to apply actuarial methods and modeling techniques. Verifies and documents assumptions, justifies analysis and recommendations with sound logic and actuarial principles, and adheres to Actuarial Standards of Practice.

Competencies:

• Building Trust
• Building a Successful Team
• Aligning Performance for Success
• Building Customer Loyalty
• Building Strategic Work Relationships
• Continuous Improvement
• Decision Making
• Facilitating Change
• Leveraging Diversity
• Driving for Results

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Skills:

Accountable leadership, Business & financial acumen, Data-driven & Analytical, Decision Making, Empowerment, Influential Communications, Situational Leadership, Strategic Planning

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range:

$127,338.01 - $216,474.62

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.

• We are one team working toward a common goal.

• We are each responsible for customer service.

• We practice open communication at all levels of the company to foster individual, team and company growth.

• We actively participate in efforts to improve our many communities-internally and externally.

• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.

• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.