Health Business Manager
Overview
The Health & Benefits Actuary supports client engagements by performing actuarial valuations, financial modeling, cost projections, and strategic analysis for employer health and welfare plans. This role partners with consultants, analysts, and senior actuaries to deliver data‑driven insights that help clients manage plan costs, evaluate funding strategies, and understand risk. The ideal candidate has strong technical acumen, experience with large employer health plans, and the ability to communicate complex actuarial results in a client‑friendly way.
Key Responsibilities
Actuarial & Financial Analysis
- Develop and review medical, pharmacy, dental, and disability cost projections, trend analyses, and renewal estimates.
- Perform actuarial modeling for funding approaches (fully insured, level‑funded, self‑funded, stop‑loss).
- Conduct claims experience reviews, IBNR reserving, and financial reconciliations.
- Support pricing and evaluation of plan design alternatives using actuarial tools and proprietary models.
Client Support & Consulting
- Translate complex actuarial findings into clear recommendations for clients.
- Prepare client‑ready presentations, financial exhibits, and analysis narratives.
- Participate in client meetings to explain results, trends, and cost drivers.
- Support annual strategic planning, forecasting, and budgeting discussions.
Vendor Evaluation & Market Support
- Assist with carrier negotiations by validating renewal calculations and underwriting assumptions.
- Evaluate vendor proposals and conduct comparative financial analyses.
- Monitor market trends in healthcare pricing, cost drivers, and regulatory impacts.
Regulatory & Compliance Analysis
- Interpret the financial implications of regulations such as ACA, Mental Health Parity, COBRA, and ERISA.
- Assist with ACA reporting and actuarial certifications when required.
- Stay current on actuarial standards and professional practice guidelines.
Project Management & Collaboration
- Lead workstreams within larger client engagements.
- Supervise and review work of junior analysts.
- Collaborate across actuarial, data analytics, compliance, and consulting teams.
- Ensure accuracy, documentation, and adherence to actuarial standards (ASOPs).
Qualifications
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field.
- 4-7 years of actuarial experience in health & benefits consulting, brokerage, or carrier/underwriting roles.
- Associate of the Society of Actuaries (ASA) required; near‑FSA preferred.
- Strong working knowledge of employer health & welfare plans (medical, Rx, dental, life/disability).
- Proficiency with actuarial modeling tools, Excel, and data analytics platforms.
- Strong analytical mindset with the ability to explain complex results clearly.
- Excellent communication and client‑facing skills.
Preferred Skills
- Experience with large‑market or jumbo employer groups, public sector, or union/multi‑employer plans.
- Familiarity with stop‑loss pricing, pharmacy claims analysis, or value‑based plan modeling.
- Knowledge of data tools (SQL, Python, R) a plus but not required.
- Ability to manage multiple deadlines and lead components of client delivery.
FAQs
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