Actuarial Director – Level Funding Pricing

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.

• 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.

• 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).
• 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.

• 401k matching
• Health insurance
• Flight privileges
• Short and long term disability benefits
• 401(k) +match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.