Actuarial Director, Pricing

PacificSource Health Plans

. Direct all actuarial pricing and related services .

Posted 10/17/2026full-timeRemote • North Carolina • United StatesLead💰 $127,338 - $216,475 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive actuarial expertise with a focus on pricing, risk analysis, and regulatory compliance, while effectively leading teams and managing actuarial processes. Proficient in developing premium rates and maintaining actuarial standards within the health insurance domain.

Highest-signal resume keywords

Actuarial PricingManagement ExperienceHealth ExperienceFellowship in Society of ActuariesActuarial Standards of Practice

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Actuarial MethodsModeling TechniquesRate FilingsRisk AdjustmentForecastingBudgetingPremium Deficiency ReserveStatistical AnalysisProcess ImprovementLean Methodologies

Soft Skills

LeadershipCommunicationProblem-SolvingCollaborationCoaching

Certifications & Qualifications

Fellow in Society of ActuariesActive Member of American Academy of Actuaries

Industry Keywords

Commercial BusinessMedicare AdvantageRegulatory ComplianceUnderwriting PoliciesP&L ManagementActuarial CertificationsRisk SharingPerformance ReviewsHIPAA ComplianceHealth Economics

About the role

Key responsibilities & impact

Direct all actuarial pricing and related services
Ensure accurate and reliable actuarial activities and sound actuarial analysis of risk
Develop premium rates for Commercial business and Medicare Advantage bids
Prepare rate filings, bids, supporting exhibits, actuarial certifications, memoranda, and statements of opinion
Direct development, implementation, and maintenance of rating and pricing models
Coordinate with departments to ensure regulatory compliance and consistency with rating and underwriting policies
Support reserving, forecasting, budgeting, risk adjustment, risk sharing, premium deficiency reserve, and year-end actuarial opinion processes
Direct analysis of risk, cost, and utilization with the Actuarial Director of Health Economics
Lead and supervise actuarial students, credentialed actuaries, and non-actuarial analysts
Assist with hiring, staff development, coaching, performance reviews, corrective actions, and terminations
Maintain collaborative partnerships with Underwriting, Product Development, Sales, and Finance
Participate in strategic and internal committees
Support Medicare Advantage and Commercial P&L owners on financial loss ratio initiatives
Lead process improvement and promote lean methodologies
Participate in PacificSource research activities
Meet department and company performance and attendance expectations
Follow privacy policy and HIPAA confidentiality and security requirements
Perform other duties as assigned

Requirements

What you’ll need

At least six years of actuarial experience
At least three years of management experience
Health experience preferred
Baccalaureate degree in mathematics, statistics, actuarial science, or a related field
Enrolled as Fellow in Society of Actuaries
Active member in good standing of American Academy of Actuaries
Knowledge of actuarial methods and modeling techniques
Ability to verify and document assumptions and justify analysis using actuarial principles
Adherence to Actuarial Standards of Practice
Ability to accomplish tasks accurately under pressure, determine priorities, and meet deadlines
Ability to identify problems, design and implement solutions, and monitor results
Ability to read and comprehend written and spoken English
Ability to communicate clearly and effectively
Ability to work in a general office setting with ergonomically configured equipment
Ability to stoop, bend, sit and/or stand for extended periods, perform repetitive motions, and lift/carry files and business materials
Approximately 5% travel required

Benefits

Comp & perks

Equal opportunity employment
Work-from-home arrangement indicated by location field (WFH: NC)
Professional development through actuarial student program updates and staff development
Coaching, performance reviews, and regular one-on-ones
Participation in strategic and internal committees
Continuous improvement and lean methodology initiatives