Director, Healthcare Economics

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Internal candidates are not required to relocate near an office.

The opportunity: The Director of Healthcare Economics will support the Health & Risk Solutions business via the Actuarial Pricing team. Primary focus will be pricing PPO Networks, PBMs, TPAs, and measurement of health capability vendor offerings within our Stop-Loss product. This role will work with Distribution, Underwriting, and Health Capabilities teams to identify, manage, and capitalize on viable growth opportunities.

How you will contribute:

• Develop and enhance rate study methodologies
• Establish and maintain effective pricing models for evaluating traditional medical networks
• Identify, evaluate, and monitor new medical network structures (ACOs, reference-based pricing, narrow networks)
• Provide ongoing pricing assessments of administrators and PBMs as well as any associated cost containment programs
• Evaluate impact of external vendors on catastrophic claims and develop strategies to reflect impact in stop-loss pricing
• Lead the development of measurement techniques for health capability offerings
• Proactively search for additional information used to enhance pricing models
• Identify and execute corrective actions as needed to manage pricing for networks, TPAs, PBMs, and other vendors
• Partner with Underwriting, Distribution, and Product Management to identify, support, and grow profitable relationships or fix unprofitable relationships
• Act as a subject matter expert related to network offerings, vendor capabilities, and their associated values to both internal and external partners, including serving as relationship manager on key partnerships
• Proactively identify opportunities to share information with business partners through formal training sessions, internal documentation, etc.
• Provide leadership and direction to Healthcare Economics team, develop and monitor performance of others

What you will bring with you:

• Ability to work with a diverse range of people
• FSA with 7+ years of proven healthcare actuarial experience, stop-loss experience a plus
• Superior analytical, technical, and communication skills
• Ability to deal with imperfect data, and identify supplemental data sources
• Proven ability to navigate and manage ambiguous situations effectively
• Ability to work across different functional areas
• Prior experience with medical networks or provider contracting a plus
• Prior management experience preferred

Salary:

$153,400-$230,100

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We\'re proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we\'ve also been recognized as a \"Top 10\" employer by the Boston Globe\'s \"Top Places to Work\" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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