Actuarial Director – Level Funding Pricing

Actuarial Director – Level Funding Pricing

Location:

This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The ideal candidate will reside in Indianapolis, IN or Atlanta, GA.

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.
• Light travel may be required.

• 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.

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.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce…