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Senior Actuarial Analyst

4 months ago

Pretoria, South Africa HR Genie Full time
Job Title: Senior Actuarial AnalystLocation:

Tshwane Metro, Pretoria, Brooklyn

Job Type:

Permanent, Full-Time

Primary Industry:

Health, Medical and related

Secondary Industry:

Insurance

Job Duties:
  • Carry out member and supplier data analyses and forecasting
  • Improve the data warehouse reports in conjunction with the BI department
  • Collect data from relevant sources and perform actuarial analyses modelling and reporting as required
  • Assist in maintaining and developing processes to monitor current projections and experience
  • Review demographics and financial claims data on a monthly basis
  • Monitor, analyse, and interpret compliance with benefit utilisation regarding specific subsets
  • Analyse hospital data on utilisation and alternative reimbursement model performance
  • Ensure the compilation of all annexures for the Council for Medical Schemes relating to members
  • Compile annual utilisation return for submission to the CMS
  • Compile all utilisation reports to comply with regulatory requirements
  • Communicate actuarial modelling analysis and investigations to relevant stakeholders clearly
  • Ensure adherence to Legislative and regulatory prescripts, Enterprise risk management frameworks, Medihelp policies guidelines and directives
Required Qualifications:

A relevant BSc degree in Actuarial Science studying toward becoming a healthcare actuary

Knowledge and Skills:
  • Strong analytical and mathematical skills
  • Excellent communication and presentation abilities
  • Proficiency in data analysis and reporting
  • Knowledge of actuarial modelling and forecasting techniques
  • Understanding of healthcare and insurance industries
  • Three years relevant experience in managed care, health risk management, service/product pricing, or scheme benefit design/healthcare product benefit design, including three years of experience in pricing and designing value-added products within the medical scheme environment, along with MS SQL programming skills
Preferred Qualifications:

Progress towards actuarial certification

Working Conditions:

This role is office-based with occasional travel required for meetings or training.

Closing date 23 July 2024