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Senior Actuarial Analyst
4 months ago
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
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
Progress towards actuarial certification
Working Conditions:This role is office-based with occasional travel required for meetings or training.
Closing date 23 July 2024