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Health Plan Actuary
3 months ago
A Health Plan Actuary Director applies knowledge of mathematics, probability, statistics, and principles of
business to provide technical support for rating/pricing, valuation, reserving, healthcare economics, and/or
financial forecasting. In this role, the actuary will build and test new actuarial models, assist with financial
statements (including a Statement of Actuarial Opinion), and MLR calculations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
● Provide strategic direction and leadership to the actuarial team.
● Develop and implement actuarial policies and procedures that align with the company’s goals and objectives.
● Collaborate with senior management to support the development and execution of the company’s strategic plan.
● Oversee the preparation of actuarial analyses, including pricing, reserving, and financial forecasting.
● Ensure accuracy and timeliness of actuarial reports and presentations to management, regulators, and other stakeholders.
● Develop and maintain actuarial models to support decision-making processes.
● Lead the actuarial team in developing and pricing new health insurance products.
● Analyze competitive market data and trends to inform product development and pricing strategies.
● Collaborate with the marketing and product development teams to ensure the actuarial soundness of new products.
● Monitor and evaluate the financial performance of the health plan’s products.
● Provide insights and recommendations to improve profitability and financial sustainability.
● Assist in the development of annual budgets and long-term financial plans.
● Other projects as assigned
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions:
● Advanced analytical skills and creative problem-solving abilities with an attention to detail.
● Sound knowledge of actuarial techniques and standards.
● Able to translate and effectively communicate financial models and the results of actuarial analyses.
● Capable of working on multiple projects under tight deadlines.
● Excellent organizational and time management skills.
● Commercial awareness with an understanding of broader business issues.
EDUCATION and/or EXPERIENCE
● Minimum of five years of experience in actuarial work with a focus on pricing large-group healthcare plans.
● Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.
● Fellow of the Society of Actuaries (FSA) designation highly desired, ASA required.
● Member of the American Academy of Actuaries (MAAA) preferred or ability to join.
● Experience with all or part of pricing model development and maintenance, including data management
and predictive analytics.
