Network Pricing Actuary
OnsiteNot SpecifiedPricing & RatingUW Support & Portfolio ManagementPredictive Modelling & ML
Role Summary
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Senior health actuarial role focused on network pricing and provider contracting within a regional health plan in Pasadena, CA. You will lead modeling and analyses to support major contract negotiations, present findings to senior leaders, and drive network performance management. Requires actuarial associate credential and extensive actuarial experience.
JOB DESCRIPTION SUMMARY
- Regional lead for network pricing and provider contracting analytics
- Develop and oversee modeling to support major contract negotiations
- Present analyses to VPs of provider contracting, market CFOs, and SVP
- Coach and delegate to network pricing analysts without direct reports
- Requires Associate of CAS or SOA and at least 8 years' actuarial experience
DOMAIN EXPERTISE
- Provider contracting and network strategy
- Modeling to support major provider negotiations
- Network performance management and analysis
- Actuarial documentation for financial reporting and tax
KEY REQUIREMENTS
- Minimum 8 years of actuarial experience
- Associate of the CAS (ACAS) OR Associate of the SOA (ASA)
- Experience with provider contracting and network strategy
- Ability to present analyses to senior leaders (VP/CFO/SVP)
TECH STACK
- No tech stack specified
