Senior IT Engineer taking ownership of complex issues and mentoring junior engineers at a hybrid role in Edinburgh. Engaging with clients and ensuring IT systems security and reliability.
About the role
- Principal Actuary providing oversight on Pharmacy Benefit Management processes at Blue Cross NC. Engaging in contract modeling, analytics, and strategic collaboration to enhance pharmacy benefits.
Responsibilities
- Translate complex PBM contractual terms into robust financial/actuarial models, ensuring all contractual requirements are met or exceeded.
- Lead the setup and implementation of new, complex PBM arrangements.
- Perform detailed PBM rebate reconciliations, ensuring accuracy in financial forecasting and payment accuracy.
- Develop and maintain sophisticated models to forecast rebates, analyze pharmacy cost trends, and identify opportunities for savings.
- Work with key stakeholders (Pharmacy Operations, Finance, Legal) to align pharmacy strategy with broader health plan goals.
- Monitor industry news, regulatory changes, and competitive landscape to maintain a competitive position.
- Indirectly manage and mentor less senior actuarial team members, fostering growth in pharmacy financial acumen.
Requirements
- Bachelor's degree or advanced degree (where required)
- Associate of the Society of Actuaries(ASA) and Member of the American Academy of Actuaries (MAAA)
- 5+ years of experience in related field
- In lieu of an ASA, alternate actuarial credentials may be considered.
- In lieu of 5 years of experience, may consider candidates who are Fellows of the Society of Actuaries (FSA).
- Experience with PBM contract negotiation, GPOs, 340b, Pharmacy Network Contracting, and/or Pharmacy Rebate Contracting – Highly Preferred
- Experience with Specialty Pharmacy modeling
- Excellent verbal and written communication skills, with the ability to explain complex financial/actuarial information to non-technical audiences and senior leadership.
- Proven ability to build relationships and work effectively with internal and external partners. – Highly Preferred
- Expert-level knowledge of SAS, SQL, and advanced Excel – Highly Preferred
- Experience building complex financial models.
- Exceptional analytical and creative problem-solving skills.
- Ability to work effectively in a team-based, collaborative environment.
- Self-motivated, resourceful, and able to work independently in a fast-paced, high-growth environment.
Benefits
- Medical, dental, and vision coverage along with numerous health and wellness programs.
- Parental leave and support plus adoption and surrogacy assistance.
- Career development programs and tuition reimbursement for continued education.
- 401k match including an annual company contribution.
Job title
Job type
Experience level
Salary
Degree requirement
Tech skills
Location requirements
Lead IT service delivery and operational technology support at Integra. Ensure systems, user experience, and support structure scale with the business needs.
IT Support Specialist for user help desk in Berlin, managing queries and improving IT processes. Need strong IT support experience and proficiency in Windows and MS 365.
Audit Manager leading multiple audit, review, and compilation engagements for Abdo's Business Audit team. Cultivating client relationships and ensuring high - quality project delivery.
On - Call IT Technician providing hands - on IT support at Hartsfield - Jackson Atlanta International Airport, focusing on hardware maintenance and repair.
Associate Engineer for Broadcast IT management during live productions and daily operations. Responsible for technical success at Warner Bros. Discovery events, requiring troubleshooting and support skills.
Manager at PwC facilitating successful deal processes and integrations in complex transactions. Leading teams and ensuring quality standards in delivering value for clients.
IT Infrastructure Analyst responsible for design and maintenance of network and security systems at the manufacturing site. Provides support and coordinates for IT infrastructure projects.
Unit Manager overseeing nursing staff and operations in skilled nursing facility. Leading care coordination and ensuring high - quality standards in a resident - focused environment.
IT Infrastructure Director overseeing strategy, delivery, and operations of technology infrastructure. Ensuring reliable and secure technology platforms across data centers and cloud services.