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Principal Actuary – Pharmacy Benefit Manager Oversight
Location
Kentucky + 4 moreAll locations: Kentucky, Louisiana, North Carolina, Mississippi, South Carolina
Posted
12 days ago
Salary
$118.7K - $189.9K / year
Bachelor Degree5 yrs expExperience acceptedEnglishSQL
Job Description
• Translate complex PBM contractual terms into robust financial/actuarial models, ensuring all contractual requirements are met or exceeded.
• Lead the setup and implementation of new, complex PBM arrangements.
• Perform detailed PBM rebate reconciliations, ensuring accuracy in financial forecasting and payment accuracy.
• Develop and maintain sophisticated models to forecast rebates, analyze pharmacy cost trends, and identify opportunities for savings.
• Work with key stakeholders (Pharmacy Operations, Finance, Legal) to align pharmacy strategy with broader health plan goals.
• Monitor industry news, regulatory changes, and competitive landscape to maintain a competitive position.
• Indirectly manage and mentor less senior actuarial team members, fostering growth in pharmacy financial acumen.
Job Requirements
- Bachelor's degree or advanced degree (where required)
- Associate of the Society of Actuaries(ASA) and Member of the American Academy of Actuaries (MAAA)
- 5+ years of experience in related field
- In lieu of an ASA, alternate actuarial credentials may be considered.
- In lieu of 5 years of experience, may consider candidates who are Fellows of the Society of Actuaries (FSA).
- Experience with PBM contract negotiation, GPOs, 340b, Pharmacy Network Contracting, and/or Pharmacy Rebate Contracting – Highly Preferred
- Experience with Specialty Pharmacy modeling
- Expert-level knowledge of SAS, SQL, and advanced Excel – Highly Preferred
- Experience building complex financial models.
Benefits
- 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
- Work-life balance, flexibility, and the autonomy to do great work.
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