Associate Director, Actuarial Strategy

What you’ll do

In a few words…

Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

The Associate Director, Actuarial Strategy will lead the development and execution of our data-driven strategic initiatives, including pivotal models that explain current financial impacts, predict future spending and translate any areas of uncertainty. This role will drive the transformation of complex medical and pharmacy data into actionable insights and financial strategies that shape current and future client solutions. You will serve as a senior thought leader and trusted advisor across the organization by leveraging deep actuarial expertise and advanced analytics to inform enterprise decisions, drive value creation, and fuel innovation.

The fundamentals for the job…

• Lead development of cutting-edge predictive models using regression, ML, and simulation to forecast drug spend
• Develop ongoing short, mid, and long-range forecasts of rebates, trends, revenue, and expenses for Abarca and its clients.
• Develop actuarial work products that inform business decision making.
• Develop prescriptive frameworks that translate model insights into targeted interventions (e.g., outreach sequencing, formulary design, provider strategies)
• Craft financial impact modeling for changes in risk, utilization management, and trends.
• Forecast trends using typical market indicators and Abarca innovative solutions. This can be done using any combination of methods (i.e., explanatory variables, simulation modeling, judgmental, and experience).
• Create models that showcase Abarca’s value proposition.
• Assist in modeling the impact of new regulations and quality measures (i.e., STARs).
• Communicate key results to executives and functional leads.
• Develop other financial models for critical priorities as needed.
• Support the development of analytic models to empower the underwriting team when developing pricing strategies and financial guarantees for prospective clients.
• Stay ahead of the curve on predictive analytics and payor trends to continuously refine tools and approaches
• You will have a pivotal role and be included in strategic leadership discussions and decisions.

What we expect of you

The bold requirements…

• Bachelor’s Degree or Master’s Degree in Statistics, Computer Science, Mathematics, Social Science, Finance, or a related field. (In lieu of a degree, equivalent experience may be considered).
• 10+ years’ experience as an actuary in medical or pharmacy benefits or healthcare payor analytics, including PBM, MA, or consulting
• Expertise in SQL, Python/R, ML libraries, and tools like SAS, PowerBI, or Tableau
• Demonstrated experience in building predictive models for drug spend and quality metrics, with complex claims/pharmacy datasets
• Experience in driving and taking ownership for creating cost savings and ROI models.
• Strong communicator with ability to influence clinical, financial, and executive stakeholders.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to haves…

• Fellow or Associate in the Society of Actuaries (FSA or ASA).
• Experience with Commercial, Medicare, and Medicaid revenue methodologies as well as APMs and Value-Based Care contracts and creating value proposition models.
• Experience as a professional actuary, including Medicare Advantage and Part D bidding trend and forecasting analytics.
• Coding skills, preferably SAS, VBA, SQL, Python, and R.

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Abarca Health LLC does not sponsor employment visas at this time”

The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.

Originally posted on Himalayas