Key Facts

Remote From:

Anywhere

Full time

Expert & Leadership (>10 years)

English

Hard Skills

Other Skills

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Team Leadership
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Quality Assurance
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Microsoft Office
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Decision Making
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Organizational Skills
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Persuasive Communication
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Detail Oriented
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Verbal Communication Skills

RxBenefits, Inc.

Pharmaceuticals

About RxBenefits, Inc.

Founded in 1995 and headquartered in Birmingham, AL with an office in Towson, MD, RxBenefits is the employee benefit industry’s first and only technology-enabled pharmacy benefits optimizer (PBO). Today, we employ more than 700 pharmacy pricing, data, and clinical experts to deliver prescription benefit savings to employee benefit consultants and their self-funded clients. RxBenefits exists to ensure EBC’s can offer mid-sized employers and their members an affordable pharmacy benefit solution combined with a Fortune 100 service experience. Our unique approach is enabled by our market-leading purchasing power, independent clinical solutions and high-touch superior service, allowing our clients to achieve their pharmacy program objectives. RxBenefits’ unwavering commitment to keeping pharmacy benefits affordable has created a better solution for the ever-changing market. RxBenefits provides equal opportunities for everyone that works for us and everyone that applies to join our team, without regard to sex or gender, gender identity, gender expression, age, race, religious creed, color, national origin, ancestry, pregnancy, physical or mental disability, medical condition, genetic information, marital status, sexual orientation, any service, past, present, or future, in the uniformed services of the United States (military or veteran status), or any other consideration protected by federal, state, or local law.

Company type: SME

Industry: Pharmaceuticals

Founded: 2018

Company size: 501 - 1000

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Job description

RxBenefits is hiring! We are adding an Actuarial Director to our growing Pricing Team, reporting to the Senior Director, Pricing Strategy!

The Actuarial Director is a key contributor to the success of growing RxBenefits. The role is Responsible for strategy execution and operational direction of actuarial efforts within our Commercial Pharmacy line of business. The Actuarial Director will lead a team who drives the development of models, pricing strategies, and risk assessments to support organizational objectives and influence key business decisions.

Essential Job Responsibilities Include:

Directs and provides leadership support for our 360 and IlluminateRx lines of business by setting and guiding actuarial initiatives. Ensures compliance with regulatory requirements and actuarial standards.
Assesses and manages financial risk, including recommendations for mitigation and alternative financial solutions
Develops pricing for new benefits, models financial impacts of alternative rating arrangements, and contributes to the corporate financial plan and multi-year forecast.
Designs and prepares actuarial reports for clients, brokers, and internal stakeholders
Development of trend assumptions (Utilization, Cost, Pipeline, Seasonality, etc)
Participates in audit activities, as assigned
Responsible for hiring and maintaining actuarial staff, which includes interviewing and selection of personnel, completing performance reviews, counseling staff, and other administrative matters. Develops professional staff by identifying and coordinating training needs for actuarial program.
Provide actuarial support for pharmacy initiatives, RFPs, broker/client relations, program ROI, and acquisition targets.
Collaborate effectively with cross functional stakeholders, including senior leadership, PBMs, actuaries, brokers, and other vendors.
Deliver actionable insights that improve financial performance and forecasting capabilities.
Participate in strategic and cross-functional meetings, ensuring alignment on business goals and operational efficiencies.
Oversee and prioritize workload distribution, ensuring optimal resource allocation and timely project execution.
Create, update, and standardize Standard Operating Procedures (SOPs) to ensure clarity and compliance across teams.
Create, maintain, and lead training initiatives including conducting training sessions, introducing new hires to job responsibilities, company policies, and procedures.
Organize, refresh, and enhance training materials to support ongoing employee development and knowledge retention.
Own and manage template updates including pricing, formulary, legal, product, and formulary changes while also identifying opportunities to streamline and improve template design and functionality to enhance efficiency.
Perform accuracy reviews and additional support functions for the leadership team on RxBenefits Pricing updates across all partner PBMs.
Generate and deliver ad hoc reports across various business topics providing timely and accurate data insights to support decision-making processes and to drive organizational improvements across departments.

Required Skills / Experience:

Bachelor's degree in actuarial science, Mathematics, Statistics or another related field.
7+ Years Actuarial experience in a pharmacy / managed care setting
5+ years 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, operations, and existing regulations.
Awareness of legal, political, economic, and environmental impacts on the Commercial Pharmacy insurance product and operation.
Organizational skills. Good judgment. Ability to persuade, negotiate or influence. Strong verbal and written communication skills including presentation skills.
Advanced Knowledge of Microsoft Office
Advanced Computer programming skills / languages (SAS, SQL, etc)
Ability to explain technical subjects to a non-technical audience.