This position leads the pricing function for all Medicare products within Pharmacy. Responsible for leading all financial aspects of product design, cost mitigation strategies, and pricing strategies to yield adequate return on capital for Medicare Part D products. Also responsible for providing network and rebate analytics for Magellan Rx as business priorities warrant.
Provides leadership and guidance to external actuarial consultants in develop all assumptions for Part D pricing bids annually, including prioritization of consultant work activity.
Recommends product enhancements to ensure ongoing financial strength of Medicare book of business.
In coordination with key functional areas (Network, Clinical, Operations, Rebate and Actuarial Vendors), leads financial aspects of formulary design and network economics for Part D products. Secures commitment from business partners to achieve operational outcomes necessary to achieve cost savings assumed in pricing projections.
Represents Magellan for interactions with CMS during any potential bid audits. Sets priorities for pricing projects, working with business unit leadership and finance staff.
Prepares budget projections for Part D program, analyzes emerging monthly financial results, and prepares updated outlook of calendar year results. Leads identification of and tracking progress against any additional actions to improve results throughout the year.
Provides advanced analytical support in other areas of assigned SBU, including Network analytics and Rebate analytics as business priorities warrant.
Potential future staff leadership of new analyst positions depending on growth of Part D business and insourcing of portions of actuarial consultant bid pricing work, and network and rebate analytics.
Other duties as assigned.
Bachelors (Required), Masters
License and Certifications - Required
FSA - Fellow of the Society of Actuaries - Enterprise
License and Certifications - Preferred
Other Job Requirements
12+ years qualifying work experience.
Strong Knowledge of pricing principles in a managed care environment.
Excellent written and verbal communication skills.
Ability to self-start and work independently.
Good analytical, reasoning and problem solving skills.
Strong organizational skills and must be able to adhere to strict deadlines.
Willingness to learn new product lines and adapt to changing environment.
Strong working knowledge Microsoft Office Product suite, specifically Excel, and experience with managing large data sets.
Actuarial pricing experience required.