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PacificSource Health Plans
PacificSource Health Plans
1 001 – 5 000 Darbuotojai
DraudimasSveikatos draudimasSveikatos priežiūra
„PacificSource Health Plans“ yra sveikatos draudimo organizacija, teikianti paslaugas asmenims, šeimoms, darbdaviams ir viešųjų programų dalyviams. Jos draudimo pasiūlą sudaro individualūs ir šeimos planai, darbdavių apmokamas draudimas, „Medicare“ ir „Medicaid“ draudimas, dantų priežiūros draudimas bei grupinių planų administravimo paslaugos. Bendrovė taip pat padeda savo nariams teikdama klientų aptarnavimą, sveikatos valdymo išteklius, psichikos sveikatos pagalbą ir gerovės programas.
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Actuarial Director, Commercial Pricing and Medicare Advantage

Lead Commercial pricing and Medicare Advantage bids at PacificSource Health Plans, directing actuarial teams and pricing strategy. Oversee rates, models, regulatory filings, risk analysis, and financial planning.

USJungtinės ValstijosNCŠiaurės Karolina
127 338 $ – 216 474 $ / metai
NuotolinisVisas etatasVadovasPrivaloma Kalba: anglųAktuaras

Aprašymas

  • Lead actuarial pricing and related services.
  • Ensure actuarial work is accurate and reliable, with sound risk analysis.
  • Set premium rates for Commercial business and prepare Medicare Advantage bids.
  • Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion.
  • Oversee the development, implementation, and maintenance of rating and pricing models.
  • Coordinate across departments to support regulatory compliance and alignment with rating and underwriting policies.
  • Support reserving, forecasting, budgeting, risk adjustment, risk sharing, premium deficiency reserves, and year-end actuarial opinion processes.
  • Direct risk, cost, and utilization analysis with the Actuarial Director of Health Economics.
  • Lead and supervise actuarial students, credentialed actuaries, and non-actuarial analysts.
  • Support hiring and staff development, including coaching, performance reviews, corrective actions, and terminations.
  • Build collaborative partnerships with Underwriting, Product Development, Sales, and Finance.
  • Contribute to strategic and internal committees.
  • Support Medicare Advantage and Commercial P&L owners on financial loss ratio initiatives.
  • Lead process improvements and promote lean methods.
  • Take part in PacificSource research activities.
  • Meet department and company performance and attendance expectations.
  • Follow privacy policies and HIPAA confidentiality and security requirements.
  • Carry out other duties as assigned.

Reikalavimai

  • Bring at least six years of actuarial experience and at least three years of management experience.
  • Health insurance 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.
  • Maintain active membership in good standing with the American Academy of Actuaries.
  • Know actuarial methods and modeling techniques.
  • Verify and document assumptions, and support analyses using actuarial principles.
  • Adhere to Actuarial Standards of Practice.
  • Work accurately under pressure, set priorities, and meet deadlines.
  • Identify problems, develop and implement solutions, and monitor results.
  • Read and understand written and spoken English.
  • Communicate clearly and effectively.
  • Work in a general office setting with ergonomically configured equipment.
  • Be able to stoop, bend, sit or stand for extended periods, perform repetitive motions, and lift or carry files and business materials.
  • Travel approximately 5%.
  • fields

Privalumai

  • Equal opportunity employer.
  • Remote work arrangement for North Carolina, as indicated by the work-from-home location.
  • Professional development through actuarial student program updates and staff development.
  • Coaching, performance reviews, and regular one-on-one meetings.
  • Opportunity to participate in strategic and internal committees.
  • Involvement in continuous improvement and lean methodology initiatives.

Susiję darbai

Devoted Health

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

Devoted Health
1 001 – 5 000 Darbuotojai
Gera savijautaSveikatos draudimasSveikatos priežiūra
USJungtinės Valstijos
175 000 $ – 250 000 $ / metai
NuotolinisVisas etatasVyresnysis specialistasVadovasPrivaloma Kalba: anglųAktuaras
PythonSQL

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.

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