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Role Description

The Actuarial Principal, EGWP Pricing & Strategy is a senior actuarial leader responsible for the end-to-end pricing strategy, financial modeling, and proposal development for fully insured Employer Group Waiver Plans (EGWPs). This role blends deep Medicare Part D/EGWP technical expertise with executive-level influence to drive profitable growth, enterprise value creation, and client retention/expansion.

• Own the pricing strategy, rate development and risk management for the Medicare Part D Fully Insured Employer Group Waiver Plan across new sales and renewals.
• Lead the creation and review of client pricing proposals, ensuring they are actuarially sound, compliant, and aligned with enterprise financial goals and client growth goals.
• Collaborate with executive leadership to align actuarial insights with business goals.
• Develop scenario-based pricing options, articulating trade-offs in profitability vs. growth.
• Drive portfolio-level financial performance through pricing discipline and risk management.
• Evaluate and recommend strategies that improve long-term enterprise value.
• Serve as a strategic partner to Sales and Account teams—helping craft winning proposals.
• Provide market insights on competitive positioning and pricing approaches.
• Participate in external client meetings to explain pricing and negotiate terms.
• Collaborate with external Third Party Administer (TPA) on competitive pricing bids.
• Translate complex actuarial findings into executive-ready narratives.
• Perform financial analyses of proposed regulatory changes and special programs by CMS.
• Oversee development and refinement of actuarial models.
• Analyze large datasets to inform pricing, forecasting, and financial reporting.
• Ensure models and outputs align to internal policies and regulatory guidance.
• Develop and maintain actuarial models for prospective projections of Medicare Part D Plan client’s plan liability.

Qualifications

• Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) designation (FSA preferred).
• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or related field (or equivalent experience).
• 10+ years of actuarial experience in health insurance, with direct EGWP and/or Medicare pricing experience.
• Strong technical skills in Excel, Access and actuarial modeling software.
• Demonstrated experience leading pricing strategy for complex accounts.
• Strong expertise in pricing methodologies, trend development, credibility, and experience analysis.
• Advanced analytical and modeling skills (Excel required; SAS/R/Python/SQL a plus).
• Exceptional communication skills—able to present to executives and negotiate with sophisticated client stakeholders.
• Extensive understanding of US Prescription drug supply chain and Medicare knowledge, with specific acumen in Part D.

Requirements

• May be required to travel periodically (for internal and external meetings).
• Proven ability to balance enterprise profitability objectives with market/client growth needs.
• Demonstrate sound business judgment when drawing conclusions and making recommendations.
• Proven capabilities in modeling, forecasting, and predictive analytics.

Benefits

• Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k), company paid life insurance, tuition reimbursement.
• A minimum of 18 days of paid time off per year and paid holidays.
• Annual salary of 145,500 - 242,500 USD / yearly, depending on relevant factors.
• Eligible to participate in an annual bonus plan and long term incentive plan.