Lead Actuary – Pharmacy Pricing - REMOTE
Lead Actuary – Pharmacy Pricing - REMOTE
The Lead Actuary – Pharmacy Pricing leads complex pharmacy pricing and rebate guarantee analyses for Prime’s existing and prospective clients. This role partners closely with senior leaders to deliver client-specific pricing recommendations, navigate market-driven uncertainty, and translate complex analyses into clear, actionable insights. The position leads high-visibility initiatives and mentors actuarial team members.
Key Responsibilities
• Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership
• Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models
• Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results
• Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling
• Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence
• Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability
• Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback
• Monitor health policy, regulatory, and market developments and assess implications for pricing strategy
• Ensure compliance with applicable federal regulations and actuarial standards
• Perform other duties as assigned
Minimum Qualifications
• Bachelor’s degree in Math, Actuarial Science, Economics or Finance or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 8 years of actuarial work experience to include 6 years in a healthcare organization or PBM
• Actuarial designation (ASA or FSA)
• Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
• Advanced proficiency in Excel; working knowledge of SAS, SQL, VBA, or similar tools
• Strong analytical and problem-solving skills with the ability to work through ambiguity
• Ability to manage multiple complex priorities and deliver under tight timelines
• Clear, professional written and verbal communication skills
• Effective client-facing and executive presentation skills
Preferred Qualifications
• Experience pricing Commercial, Medicare, and/or Medicaid pharmacy benefits
• Demonstrated experience leading complex pricing or rebate-related initiatives
• Prior client-facing experience supporting executive-level discussions
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Apply tot his job
Apply To this Job
The Lead Actuary – Pharmacy Pricing leads complex pharmacy pricing and rebate guarantee analyses for Prime’s existing and prospective clients. This role partners closely with senior leaders to deliver client-specific pricing recommendations, navigate market-driven uncertainty, and translate complex analyses into clear, actionable insights. The position leads high-visibility initiatives and mentors actuarial team members.
Key Responsibilities
• Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership
• Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models
• Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results
• Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling
• Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence
• Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability
• Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback
• Monitor health policy, regulatory, and market developments and assess implications for pricing strategy
• Ensure compliance with applicable federal regulations and actuarial standards
• Perform other duties as assigned
Minimum Qualifications
• Bachelor’s degree in Math, Actuarial Science, Economics or Finance or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 8 years of actuarial work experience to include 6 years in a healthcare organization or PBM
• Actuarial designation (ASA or FSA)
• Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
• Advanced proficiency in Excel; working knowledge of SAS, SQL, VBA, or similar tools
• Strong analytical and problem-solving skills with the ability to work through ambiguity
• Ability to manage multiple complex priorities and deliver under tight timelines
• Clear, professional written and verbal communication skills
• Effective client-facing and executive presentation skills
Preferred Qualifications
• Experience pricing Commercial, Medicare, and/or Medicaid pharmacy benefits
• Demonstrated experience leading complex pricing or rebate-related initiatives
• Prior client-facing experience supporting executive-level discussions
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Apply tot his job
Apply To this Job