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Senior Actuarial Analyst – Pharmacy Benefit Oversight

ActuaryActuaryFull TimeRemoteTeam 501-1,000Since 1997H1B No SponsorCompany SiteLinkedIn

Location

Kentucky + 4 moreAll locations: Kentucky, Louisiana, North Carolina, Mississippi, South Carolina

Posted

15 days ago

Salary

$98.1K - $156.9K / year

Bachelor Degree4 yrs expExperience acceptedEnglishSQL

Job Description

• Model Building & Process Improvement: Design, develop, and maintain new actuarial models and analytical processes to evaluate PBM performance, vendor contracts, and pharmacy claims data. • Formulary Modeling & Strategy: Perform in-depth formulary modeling to drive lowest net cost strategies, optimizing pharmacy benefit offerings for financial and clinical outcomes. • Trend Management: Actively monitor, analyze, and manage pharmacy net cost trends (ingredient cost, rebate optimization, utilization). • Data Analytics & Insights: Proactively review advanced data analytic methods and identify opportunities to improve existing team processes. • Collaboration & Communication: Partner with pharmacy operations, clinical teams, underwriting, and finance to align on assumptions and drive cross-functional value.

Job Requirements

  • Bachelor's degree or advanced degree (where required)
  • 4+ years of experience in relevant actuarial experience. Related experience may be considered.
  • Must have completed 5 or more exams towards the eventual attainment of the ASA designation.
  • In lieu of meeting minimum exam requirements, may consider additional relevant experience.
  • In lieu of meeting minimum experience requirement, may consider ASA or more exams towards the eventual attainment of ASA.
  • Expert-level knowledge of SAS, SQL, and advanced Excel – Highly Preferred
  • Experience building complex financial models – Highly Preferred
  • Proven ability to communicate complex actuarial concepts to non-actuarial stakeholders and senior management.
  • Experience with formulary utilization management optimization – Highly Preferred
  • Highly organized, detail-oriented, and able to work independently in a fast-paced environment.
  • Strong critical thinking and creative problem-solving skills.

Benefits

  • The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community.
  • Work-life balance, flexibility, and the autonomy to do great work.
  • Medical, dental, and vision coverage along with numerous health and wellness programs.
  • Parental leave and support plus adoption and surrogacy assistance.
  • Career development programs and tuition reimbursement for continued education.
  • 401k match including an annual company contribution

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