Job Description:
• Provide actuarial leadership and oversight for DCS pricing activities, including rate reviews, underwriting, and annual pricing submissions.
• Establish and maintain actuarial standards, pricing frameworks, and governance processes.
• Review, approve, and recommend rate actions, pricing assumptions, and risk positions.
• Own actuarial evaluation of margin performance and profitability drivers.
• Ensure pricing strategies and rate execution are aligned with target margins and durable growth goals.
• Identify emerging risks and develop mitigation strategies in partnership with Business Leads, Finance and Underwriting.
• Assess and manage the financial and pricing implications of federal and state regulatory changes impacting Commercial Pharmacy and Mental Health Parity.
• Oversee intercompany pharmacy pricing discussions and work with both Caremark and Aetna IBU teams to ensure pharmacy value is effectively deployed for Fully Insured, AFA and integrated ASC business.
• Lead and mentor a multi-disciplinary team, fostering organizational agility and development.
Requirements:
• 12+ years of progressive actuarial experience with leadership responsibility
• Experience in Commercial health insurance pricing.
• Strong executive communication and influence skills.
• Manage large teams
• ASA or FSA
Benefits:
• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility