Pbm Actuarial Jobs (NOW HIRING)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As a Director of Actuarial Pricing Strategy, ORx, you will lead pricing strategy for the Pharmacy Benefit Manager (PBM) business, shaping how ORx competes in the market across RFPs, client requests, and underwriting decisions. This role positions the US actuarial function as a core commercial partner, supporting growth through disciplined, market informed pricing and solid actuarial engagement with clients and external consulting firms.
The Director is accountable for translating underwritten model outputs into clear, defensible pricing strategies that balance competitiveness, risk, and profitability. You will set the strategic direction for how pricing recommendations are developed, governed, and communicated, ensuring consistency across RFP responses, client negotiations, and deal structuring.
In this role, you will partner closely with the Actuarial Director responsible for Trend & Assumption setting, ensuring pricing strategies are informed by robust underlying assumptions while remaining focused on commercial decisions and market impact. You will partner closely with underwriting, industry relations pre-deals, sales, and finance and play a hands on leadership role in advancing pricing capabilities and ensuring pricing strategy is aligned with ORx's broader growth and financial objectives.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:

• Lead ORx PBM actuarial pricing strategy across Commerical, Medicare Part D and Medicaid lines of business, supporting RFP responses, client requests, and underwriting decisions
• Translate underwriting model outputs into clear, competitive, and financially sound pricing recommendations that balance risk, profitability, and market positioning
• Partner closely with the Director responsible for trend assumption setting to ensure pricing strategies are informed by robust assumptions while remaining aligned to commercial and market objectives
• Develop and recommend pricing structures and financial terms to support contract negotiations and effective risk management in risk based arrangements
• Serve as a key actuarial partner to sales, underwriting, industry relations, and finance, providing pricing guidance to support deal structuring, client discussions, and consultant engagement
• Support and lead actuarial contributions to RFPs, client specific analyses, and external consulting firm inquiries, representing ORx actuarial capabilities in market facing discussions
• Provide actuarial leadership on pricing performance evaluation, identifying opportunities to refine strategy based on emerging experience and market feedback
• Drive strategic initiatives to enhance pricing governance, consistency, and execution across contracts and client segments
• Communicate pricing strategy and recommendations clearly to both technical and non technical audiences through presentations, discussions, and written materials
• Mentor and support junior Actuaries and analysts, with a focus on pricing acumen and professional development

All while working in an environment that allows:

• Flexibility in your work schedule
• Inclusion into the UHG Actuarial Study Program, including company sponsored study hours and study materials

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

• ASA (Associate of the Society of Actuaries)
• 5+ years of actuarial experience in a Pharmacy or Healthcare setting
• 3+ years of experience analyzing and manipulating large healthcare claim datasets
• Demonstrated experience leading or influencing pricing decisions
• Proficiency in Excel and SQL
• Proven excellent problem-solving and communication skills, along with critical thinking skills to anticipate questions from key stakeholders and consider all aspects of a deliverable before completion

Preferred Qualifications:

• FSA, or progress toward FSA (Associate/Fellowship of the Society of Actuaries) designation
• 3+ years of experience working in a PBM Setting
• Experienced presenting business insights and summaries to inform decisions to stakeholders
• Proven ability to self-motivate, quickly learn new business concepts and take initiatives

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.