Job description
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Lead Actuary – Pharmacy Pricing - REMOTEJob 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
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and 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.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.