Actuarial Director of Pharmacy Pricing Strategy

Join RxBenefits as we expand our dynamic Pricing Team! We are seeking an innovative Actuarial Director to report directly to the Senior Director of Pricing Strategy. This pivotal role will drive the strategic execution and operational leadership of our actuarial projects within the Commercial Pharmacy sector. The Actuarial Director will lead a dedicated team focused on developing advanced models, pricing strategies, and risk assessments that align with the organization’s goals and impact significant business decisions. Key Responsibilities Include: Direct leadership for our 360 and IlluminateRx business lines, guiding actuarial initiatives while ensuring adherence to regulatory and actuarial standards. Assess and manage financial risks, providing strategic recommendations and alternatives for mitigation. Develop pricing models for new benefits and evaluate financial implications of various rating arrangements, contributing to the corporate financial strategy and long-term forecasts. Create comprehensive actuarial reports for clients, brokers, and internal stakeholders. Establish trend assumptions encompassing Utilization, Cost, Pipeline, Seasonality, and more. Participate in assigned audit activities, ensuring compliance and accuracy. Lead hiring efforts and oversee the growth of actuarial staff, including performance reviews, mentorship, and training coordination. Provide actuarial support for pharmacy initiatives, including RFPs, client relations, program ROI, and potential acquisitions. Foster collaboration among cross-functional teams, including senior leadership, PBMs, actuaries, brokers, and external vendors. Deliver actionable insights that drive financial performance and enhance forecasting capabilities. Engage in strategic meetings to ensure alignment with business objectives and enhance operational efficiency. Manage project workloads effectively, optimizing resource allocation for timely task completion. Develop and update Standard Operating Procedures (SOPs) to maintain clarity and compliance across teams. Lead training initiatives by conducting sessions for new hires and ongoing employee development. Enhance training materials continually to support knowledge retention and development. Oversee template updates for pricing and formulary changes, identifying opportunities for process improvements. Conduct accuracy reviews and support the leadership team with updates on pricing across all partnerships. Generate and present ad hoc reports on a variety of business topics, delivering timely data insights to facilitate informed decision-making and organizational improvements. Required Skills / Experience: Bachelor's degree in actuarial science, Mathematics, Statistics, or a related field. 7+ years of actuarial experience in a pharmacy or managed care environment. 5+ years of supervisory or managerial experience. Fellow of the Society of Actuaries (FSA) and Member of the Academy of Actuaries (MAAA). Extensive knowledge of Commercial Pharmacy insurance products and regulations. Aware of legal, political, economic, and environmental factors affecting Commercial Pharmacy insurance products. Strong organizational skills, alongside good judgment and the ability to influence and negotiate. Excellent verbal and written communication skills, including proficiency in presentations. Advanced knowledge of Microsoft Office and programming skills in languages such as SAS and SQL. Capability to convey complex technical concepts to non-technical audiences effectively. At RxBenefits, we are committed to providing equal opportunities for all employees and applicants, without regard to any protected characteristics.

Created: 2026-03-06