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Anthem, Inc. Actuarial Director (Pharmacy) - PS34772 in Norfolk, Virginia

Actuarial Director (Pharmacy) - PS34772

Location: Louisville, Kentucky, United States

New

Requisition #: PS34772

Post Date: 2 days ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Actuarial Director (Pharmacy)

Two Actuarial Director positions. These positions will be dedicated to ideation and analytics. One would be dedicated to Specialty Pharmacy, while the other would split time between Specialty and other sources of pharmacy ideation. Specialty Pharmacy is a recurring “hot spot” in need of trend mitigation.

Work Location: Louisville, KY preferred location

Alternate Location: Indianapolis, IN; Mason, OH; St. Louis, MO; Atlanta, GA; Waukesha, WI; Richmond, VA; or Virginia Beach, VA

The Actuarial Director identifies, evaluates and responds to financial risks inherent in the pricing and development of health insurance products.

Primary duties may include, but are not limited to:

  • Prepares and interprets data and related formulae.

  • Monitors trend of profit and profitability by line of business and/or product.

  • Serves on major, multi-function projects as Actuarial representative.

  • Organizes and directs the staffing and work flow of the section.

Qualifications:

  • Requires a BS/BA degree; FSA required from the Society of Actuaries (SOA); at least 6 years related experience; or any combination of education and experience, which would provide an equivalent background; will consider an ASA with at least 9 years of related experience.

  • Experience with SQL and/or SAS beneficial.

Other experiences, knowledge, and key skills that may positively contribute towards consideration for this role include:

  • Facility contracting experience.

  • Experience with facility billing practices intended to skirt insurer efforts to control unit costs.

  • Medical necessity/Prior Authorization experience.

  • Redirection programs experience.

  • Experience with Biosimilar.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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