PacificSource Health Plans
PacificSource Health Plans
PacificSource Health Plans жеке тұлғаларға, отбасыларға, жұмыс берушілерге және мемлекеттік бағдарламалардың қатысушыларына қызмет көрсететін медициналық сақтандыру ұйымы. Оның сақтандыру өнімдеріне жеке тұлғалар мен отбасыларға арналған жоспарлар, жұмыс беруші ұсынатын сақтандыру, Medicare, Medicaid, стоматологиялық сақтандыру және топтық жоспарларға арналған әкімшілік қызметтер кіреді. Компания сондай-ақ клиенттерге қызмет көрсету, денсаулықты басқару ресурстары, психикалық денсаулықты қолдау және салауатты өмір салты бағдарламалары арқылы қатысушыларға қолдау көрсетеді.

PacificSource Actuarial Director, Pricing (Remote in Virginia)

Lead pricing, rate filings, and risk analysis for PacificSource’s Commercial and Medicare Advantage health plans. Manage actuarial teams and support financial performance.

Сипаттама

  • Lead actuarial pricing and related services
  • Set premium rates for Commercial business and Medicare Advantage bids
  • Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and required statements of opinion
  • Oversee the development, implementation, and maintenance of rating and pricing models
  • Work across departments to support regulatory compliance and align with rating and underwriting policies
  • Support reserving, forecasting, budgeting, risk adjustment, risk sharing, premium deficiency reserve, and year-end actuarial opinion processes
  • Lead risk, cost, and utilization analysis with the Actuarial Director of Health Economics
  • Manage actuarial students, credentialed actuaries, and non-actuarial analysts
  • Support hiring, staff development, coaching, performance reviews, corrective actions, and terminations
  • Build collaborative relationships with Underwriting, Product Development, Sales, and Finance
  • Take part in strategic and internal committees
  • Help Medicare Advantage and Commercial P&L owners advance financial loss-ratio initiatives
  • Improve processes and promote lean methods
  • Contribute to PacificSource research activities
  • Follow privacy policy and HIPAA requirements, and carry out other assigned duties

Талаптар

  • Bring at least six years of actuarial experience
  • Have three years of management experience
  • Health experience is preferred
  • Hold a bachelor’s degree in mathematics, statistics, actuarial science, or a related field
  • Be enrolled as a Fellow in the Society of Actuaries
  • Be an active member in good standing of the American Academy of Actuaries
  • Know actuarial methods and modeling techniques
  • Verify and document assumptions, and support analysis with sound logic and actuarial principles
  • Follow Actuarial Standards of Practice
  • Complete work accurately under pressure, set priorities, and meet deadlines
  • Identify problems, develop and implement solutions, and monitor outcomes
  • Read and understand written and spoken English
  • Communicate clearly and effectively
  • Be able to stoop and bend, sit or stand for extended periods, perform repetitive motions, and lift or carry files and business materials

Артықшылықтар

  • Work-from-home arrangement
  • Travel approximately 5% of the time
  • Equal opportunity employment
  • Diversity, equity, inclusion, and social justice efforts
  • Ergonomically configured general office equipment

Ұқсас жұмыс орындары

Omada Health

Principal Actuary, Healthcare ROI and Risk

Omada Health

Build healthcare ROI, pricing, and risk models for Omada Health’s virtual chronic care programs. Advise payers, employers, and internal teams on performance guarantees and value-based contracts.

Ашу
Infinity Constellation

Managing Director, Pension and Retirement Plan Actuarial

Infinity Constellation

Lead Infinity Constellation’s U.S. pension actuarial business, with responsibility for actuarial sign-off and client growth. Help shape AI-enabled workflows for retirement plan services.

Ашу
Devoted Health

Senior Commercial Pricing Actuary – Devoted Health (Remote, U.S.)

Devoted Health

Lead commercial health insurance pricing, rating models, underwriting strategy, and state rate filings at Devoted Health. Guide compliant, financially sound products through actuarial leadership and cross-functional partnership.

Ашу
Devoted Health

Senior Medicare Advantage Pricing Actuary

Devoted Health

Lead Medicare Advantage bid strategy, pricing models, and CMS submissions at Devoted Health. Help improve care for older Americans through data-driven healthcare.

Ашу
P

Actuarial Director, Health Plan Pricing

PACIFICSOURCE
1 001 – 5 000 Қызметкерлер

Lead pricing, rate filings, and risk analysis for PacificSource Commercial and Medicare Advantage plans. Manage actuarial teams and support financial performance.

Ашу