Lead Actuary - Pharmacy Pricing - REMOTE

Job Description

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

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

Prime Therapeutics LLC is a proud equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation, please contact Human Resources at 1.866.469.1257 or email [email protected].