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The Actuarial Director – Level Funding Pricing is responsible for identifying, evaluating and responding to financial risks inherent in the pricing and development of health insurance products.
Job Responsibility:
Prepares and interprets data and related formulae
Monitors trend of profit and profitability by line of business and/or product
Serves on major, multi-function projects as Actuarial representative
Organizes and directs the staffing and workflow of the section
Light travel may be required
Requirements:
Requires a BA/BS degree and minimum of 6 years related experience
or any combination of education and experience, which would provide an equivalent background
FSA required from the Society of Actuaries (SOA)
Nice to have:
Prior pricing experience working within stop loss/level-funded space strongly preferred
Experience with leading and developing pricing strategies using data and analyses to guide underwriting decision-making within the stop loss/level-funded space preferred
Ability to be innovative and assess potential AI or predictive tools to assist in risk identification and/or scoring methods to guide pricing decisions preferred
Small group pricing experience within level-funded preferred
Excellent writing and presentation skills, and ability to convey technical analyses and information in a clear manner to non-technical business audiences, including C-suite, Senior HR, Finance leadership preferred, and potential external Producer partners and/or clients preferred
Experience with consulting and evaluating impact of regulatory changes, including hospital and provider price transparency, No Surprises Act, Affordable Care Act, Medicare Reference Pricing, CMS value-based payments and other health reform and industry health innovation initiatives preferred
Experience serving large/complex Fortune 500 organizations, as well as developing scaled solutions for smaller self-insured groups preferred
Ability to review technical work product and mentor junior technical staff including analysts, data scientists, statisticians and actuaries preferred
Experience working with large health claims datasets or gathering datasets. Experience with evaluation of provider quality and quality data. Experience with HIPAA and de-identification standard methodologies preferred
Well-developed skills in project management/planning and partner management preferred
What we offer:
merit increases
paid holidays
Paid Time Off
incentive bonus programs (unless covered by a collective bargaining agreement)
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