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PacificSource

Not-for-profit health insurer and benefits provider

Actuarial Director - Pricing

Actuarial & Risk ModellingPosted on Nov 13
Full-timeGeorgia, USA$127.3k - $216.5k

About the Job

Requirements

  • At least six years of actuarial experience and three years of management experience are required.
  • A baccalaureate degree in mathematics, statistics, actuarial science, or a related field is required.
  • Enrollment as an Associate or Fellow in the Society of Actuaries is required.
  • Active membership in good standing of the American Academy of Actuaries is required.
  • Ability to apply actuarial methods and modeling techniques is required.
  • Ability to verify and document assumptions, justify analysis and recommendations with sound logic and actuarial principles, and adhere to Actuarial Standards of Practice is required.
  • Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines is required.
  • Ability to identify and define problems, design and implement solutions, and monitor results in a continuous improvement cycle is required.
  • Ability to read and comprehend written and spoken English is required.
  • Ability to communicate clearly and effectively is required.
  • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing, sorting and filing, and lift and carry files and business materials is required.
  • Compliance with the PacificSource privacy policy and HIPAA laws and regulations concerning protected health information is required.
  • Travel approximately 5% of the time is required.

Responsibilities

  • Direct actuarial pricing and related services, ensuring accurate and reliable actuarial activities and sound risk analysis that supports financial and enrollment goals.
  • Develop premium rates for the Commercial line of business and Medicare Advantage bids through regular analysis that is actuarially sound, competitive, and aligned with organizational income goals.
  • Prepare required rate filings and bids and supporting exhibits, and sign actuarial certifications, memoranda, and required statements of opinion.
  • Direct development, implementation, and maintenance of rating and pricing models for the Commercial line of business, coordinating with other departments to ensure regulatory compliance and consistency with rating and underwriting policies.
  • Support reserving, forecasting, and budgeting processes for risk adjustment and risk-sharing payables and receivables, annual premium deficiency reserve evaluation, and year-end statement of actuarial opinion support.
  • Work with the Actuarial Director of Health Economics to direct analysis of risk, cost, and utilization and align pricing assumptions with enterprise cost-management activities.
  • Lead, supervise, and provide guidance and vision to actuarial students, credentialed actuaries, and non-actuarial analysts, including direction on company policies, mandates, and workflow.
  • Oversee team hiring, productivity, and work quality; assist with hiring, staff development, coaching, performance reviews, corrective actions, and employee termination; and provide regular one-on-ones and performance evaluations for direct reports.
  • Stay informed about changes to actuarial curricula and requirements and propose updates to the student program as needed.
  • Assist in developing department budgets.
  • Coordinate business activities and maintain collaborative partnerships with Underwriting, Product Development, Sales, and Finance.
  • Participate in strategic and internal committees to disseminate information and represent company philosophy.
  • Support Medicare Advantage and Commercial P&L owners with input on operational and strategic initiatives related to company financial loss-ratio goals.
  • Lead process improvement with other departments and work with staff to promote lean methodologies for continuous departmental improvement.
  • Participate in the design and execution of research activities performed within PacificSource.
  • Meet department and company performance and attendance expectations.
  • Perform other duties as assigned.

Desired Qualifications

  • Health experience is preferred.

About the Company

PacificSource

Not-for-profit health insurer and benefits provider

PacificSource is a not-for-profit health insurer serving individuals and organizations in the Northwest. It offers medical and dental benefits, self-funded employee benefit programs, Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs), and COBRA administration services. Its products work by providing employee health plans and related accounts; for employers, PacificSource can fund plans directly (self-funded) and administer benefits, claims, and related accounts on behalf of participants, while individuals receive coverage and managed care through network providers. The company differentiates itself through a long history (founded in 1933), a strong community focus, and local presence with offices across Oregon, Idaho, and Montana, emphasizing close, human-centered service. The goal is to deliver affordable, accessible health benefits and related services to people and organizations in its region, supporting healthy communities.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Springfield, IL
Founded
1933

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