Director & Actuary
HybridCommercial Employer HealthPricing & RatingRegulatory ReportingUW Support & Portfolio Management
Role Summary
Loading...HIGHLIGHTS
Director-level health actuarial role leading commercial pricing for fully insured and self-funded small group, large group, and level-funded products in the Philadelphia/Tri-State area. Owns pricing strategy, rate development, regulatory filings, and oversight of actuarial models while managing and mentoring actuarial staff. Requires ASA or FSA and 8+ years of commercial health actuarial experience.
JOB DESCRIPTION SUMMARY
- Lead pricing strategy and rate development for commercial medical and ancillary products
- Manage actuarial models, monitor utilization and unit cost trends, recommend price adjustments
- Ensure compliance with state and federal rate filing requirements and DOI interactions
- Provide leadership and mentorship to actuarial analysts and managers
- Hybrid role: 3 days in office (Tue–Thu); work must be performed in Tri-State (DE/NJ/PA)
DOMAIN EXPERTISE
- commercial health pricing
- ACA and level-funded plan pricing
- large group pricing
- rate filing and regulatory compliance
KEY REQUIREMENTS
- ASA or FSA designation with 8+ years of commercial health actuarial experience
- Proven experience with ACA, level-funded, and large group pricing
- Deep understanding of healthcare cost drivers and risk adjustment methodologies
- Proficiency with SQL, SAS, R, Python and Excel for actuarial analysis
- Experience managing teams and cross-functional projects
TECH STACK
- Excel
