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Commercial Pricing Actuary
Devoted HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive expertise in Commercial actuarial pricing, including the development of scalable rating models and regulatory rate filings. Proven ability to collaborate cross-functionally and translate complex actuarial concepts for diverse stakeholders.
Highest-signal resume keywords
Commercial Actuarial PricingActuarial ModelingRegulatory Rate FilingsSQL, Python, R, SAS ProficiencyRating Engine Development
Tech Stack
Tools & technologiesAbout the role
Key responsibilities & impact- Direct strategy, modeling, and financial execution for Commercial lines of business, including Group and Self-Funded/ASO
- Build, refine, and maintain scalable actuarial rating models and pricing engines for Commercial Large Group lines
- Partner with product, clinical, and market leadership to price competitive benefit packages
- Establish, defend, and document pricing assumptions, including manual rates, age/gender factors, area factors, trend projections, administrative expense allocations, and margin targets
- Contribute to underwriting policy and risk selection strategies for group business
- Provide actuarial oversight on complex quote requests, experience rating formulas, and credibility logic
- Design and maintain pricing methodologies for ASO products, employer-specific fee structures, and stop-loss/reinsurance coverage options
- Monitor group risk profiles, employer group renewal performance, and adverse selection dynamics
- Direct preparation, documentation, and filing of annual and quarterly Commercial rate filings across multiple state departments of insurance and regulatory bodies
- Serve as primary actuarial interface with state regulators during rate reviews
- Respond to regulatory objections, actuarial inquiries, and public comments to secure rate approvals
- Oversee ACA pricing mechanics, including HHS-HCC risk adjustment, MLR rebate calculations, state rate cap mandates, and the No Surprises Act
- Collaborate with Finance, Healthcare Economics, Sales/Distribution, Network Management, and Clinical Operations
- Prepare executive-level presentations on rate filing strategies, portfolio rate impacts, and margin projections
Requirements
What you’ll need- 8+ years of progressive healthcare actuarial experience
- At least 5+ years of direct focus on Commercial actuarial pricing, rating model development, and regulatory rate filings
- Experience building rating engines from scratch or significantly upgrading pricing tools
- Proficiency in actuarial modeling and data manipulation, including SQL, Python, R, or SAS
- Direct experience managing the full lifecycle of Commercial rate filings through SERFF
- Experience navigating state regulatory rate reviews and securing approvals on schedule
- Hands-on experience partnering with or establishing guidelines for underwriting teams
- Experience rating logic and portfolio performance tracking
- Demonstrated ability to complete complex, time-sensitive filings and pricing projects on schedule
- Exceptional interpersonal and cross-functional collaboration skills
- Ability to translate complex actuarial concepts into clear strategic choices for non-actuarial partners
- Actuarial designations are valued but optional: ASA or FSA and MAAA
- Experience interfacing with reserving, value-based contracting, or medical economics functions
- Comfort operating in a fast-paced, high-growth environment
- Formal degrees or certifications are not required; equivalent practical mastery and demonstrated track record are recognized
Benefits
Comp & perks- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above
- Commission eligibility for Sales roles
- Parental leave program
- 401K program
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Actuarial ModelingData ManipulationRating Model DevelopmentPricing MethodologiesExperience Rating LogicComplex Quote RequestsPricing Assumptions DocumentationAdverse Selection DynamicsACA Pricing MechanicsPortfolio Performance Tracking
Soft Skills
Interpersonal SkillsCross-Functional CollaborationStrategic CommunicationTime ManagementProblem-Solving
Tools & Technologies
SERFFPricing EnginesActuarial Software
Certifications & Qualifications
ASAFSAMAAA
Industry Keywords
Healthcare ActuarialCommercial Lines of BusinessGroup and Self-Funded/ASOUnderwriting PolicyState Regulatory ComplianceHHS-HCC Risk AdjustmentMLR Rebate CalculationsNo Surprises Act