Prime Therapeutics

Lead Actuary – Pharmacy Pricing - REMOTE

Prime Therapeutics$124K — $211K *
US-AnywhereRemote in United States
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor’s degree in Math, Actuarial Science, Economics or Finance; relevant work experience may be considered
  • 8 years of actuarial experience, including 6 years in healthcare or PBM
  • Actuarial designation (ASA or FSA) required
  • Eligibility to work in the U.S. without visa sponsorship
  • Advanced Excel skills; familiarity with SAS, SQL, or VBA preferred
  • Strong analytical and problem-solving skills
  • Effective communication and presentation abilities

Responsibilities

  • Serve as a subject matter expert on pharmacy pricing and rebate guarantees
  • Lead development and delivery of complex pricing analyses
  • Execute ad hoc pharmacy data analyses to evaluate performance
  • Provide strategic guidance on formulary methodology and rebate structures
  • Present analyses to senior stakeholders and address challenging questions
  • Lead cross-functional workstreams requiring judgment and accountability
  • Mentor analysts and junior actuaries with technical guidance
  • Monitor health policy and market developments for pricing strategy

Benefits

  • Comprehensive health and wellness benefits
  • 401(k) plan with employer contributions
  • Work-life balance initiatives
  • Ongoing professional development opportunities
  • Flexible working arrangements including remote work options
Full Job Description
Job Posting Title

Lead Actuary 6 Pharmacy Pricing - REMOTEJob Description

The Lead Actuary 6 Pharmacy Pricing leads complex pharmacy pricing and rebate guarantee analyses for Prime 27s 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 27s 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).

About Prime Therapeutics

Prime Therapeutics is a pharmacy benefit management company that serves health plans, employers, and government programs. The company was founded in 1998 and is headquartered in Eagan, Minnesota. Prime Therapeutics manages prescription drug benefits for more than 30 million people across the United States. The company's services include claims processing, formulary management, and clinical programs. Prime Therapeutics is owned by 18 Blue Cross and Blue Shield health plans. In 2017, the company reported revenue of $5.3 billion.
Learn more about Prime Therapeutics
Size
4,000 employees
Industry
Founded
1990

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