Job Details

Company

Navitus

About Us

Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medicationsmore affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.. Current associates must use SSO login option at to be considered for internal opportunities.

Pay Range

USD $128,961.00 - USD $170,000.00 /Yr.

STAR Bonus % (At Risk Maximum)

15.00 - Director, GM of GP, PIC

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am-5pm, CT

Remote Work Notification

ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Overview

Due to growth, Navitus Health Solutions is seeking a Director of Underwriting and Actuarial to join our team!

The Director, Underwriting and Actuarial is responsible for guiding the actuarial and financial analytics, assumptions, and modeling to support the strategic objectives of Navitus. This leader directs the development, implementation, and monitoring of pricing models and strategies, financial forecasts, trend analytics, and risk modeling for all lines of business, including Medicare, Medicaid, Commercial, Self-Funded, EGWP, and Exchange products.

The Director, Underwriting and Actuarial works collaboratively with executive leadership, underwriting, clinical, and operations teams to ensure that Navitus' products are competitive, financially sound, and aligned to client, market, and organizational strategic needs. This role also involves managing and mentoring a team of actuaries and analysts, fostering their professional growth and actuarial acumen, delivering high quality actuarial work.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Serves as a primary point of contact for clients that utilize Navitus' actuarial services for pharmacy benefits cost forecasting and management.
• Participates in new business development activity with prospective clients as the lead subject matter expert for actuarial services offered by Navitus.
• Provides oversight, guidance, and models to facilitate the actuarial analysis needed to develop financial projections for alternative plan designs.
• Supports Finance projections of long-term revenues and profitability by LOB and client.
• Provides oversight, guidance, and models to analyze population and other changes to determine the impact on projected costs for a book of business.
• Understands drug trends, new drug pipelines, patent expirations, and other factors to guide best estimate thinking around projected trend.
• Contributes to the analytics strategy for the organization, working with leaders in Analytics, Sales Financial Support, and Underwriting.
• Leads development efforts of Navitus Health Solutions pricing and risk models.
• Ensures that those responsible for managing care and cost outcomes have the clinical and financial data needed to inform the development of strategies designed to manage care and cost outcomes for defined populations. This includes consideration of payer requirements that drive drug pricing and rebates.
• Establishes actuarial policies and standards that ensure effective controls and compliance with all applicable statutory, regulatory, professional, and corporate standards and regulations.
• Develops, leads, and guides the actuarial function for the organization, ensuring that the team meets client needs and that expenses are managed within budget.
• Participates in, adheres to and supports compliance, people and culture, and learning programs.
• Performs other duties as assigned.

• Education: Bachelor's degree in Mathematics, Statistics, Actuarial Science, or a related field required.

• Certification/Licenses: Associate of the Society of Actuaries required. Fellowship preferred.

• Experience:
  • 5+ years of progressive actuarial experience (preferably in Health Insurance, pharmacy benefits management, or comparable capacity) required.
  • Experience in more than 2 functions (pricing, reserving, modeling, reporting and analysis) required.
  • 5+ years of underwriting experience in a Pharmacy Benefit Management, Managed Care, or adjacent setting.
  • Experience across multiple product offerings including Medicare, Medicaid, Commercially Insured, and Administrative Service only products required.
  • 5 years of leadership experience managing people and work product for an actuarial team required.
  • Experience in influencing leaders at a variety of levels and build consensus required.

• Top of the industry benefits for Health, Dental, and Vision insurance

• 20 days paid time off

• 4 weeks paid parental leave

• 9 paid holidays

• 401K company match of up to 5% - No vesting requirement

• Adoption Assistance Program

• Flexible Spending Account

• Educational Assistance Plan and Professional Membership assistance

• Referral Bonus Program - up to $750!