Actuarial Director, Pricing

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

• →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.

• →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.

• →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

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.