Duties and responsibilities:
- Develop and implement risk management strategies aimed at continuous rebalancing of price and costs to maintain profitability of health care plans.
- Handles the development and preparation of loss ratio reports and claims analysis.
- Handles analysis of data and provides analytical summaries to arrive at the recommendation to improve risk management and pricing strategies.
- Conducts researches on functional issues using a variety of resources. Develops and prepares reports based on the results of these researches.
- Develops, maintains, audits and reviews functional databases and identifies inconsistencies from internal and external sources.
- Interprets government regulations and internal policies as relates to healthcare insurance
- Prepares recommendations based on data summaries, trend analyses, financial analysis and business analysis for profitability in line with best practices.
- Analyze data, constructs probability tables to forecast risk a d liability for future payment benefits,
- Prepares and analyze ratings for new and renewing commercial healthcare insurance benefit package for implementation.
- Updates and reviews pricing ad rating model, trends and assumptions,
- Assists in product development activities and ensure timely and accurate Actuarial support on healthcare product development related programs and initiative.
- Prove underwriting analysis for pricing ad risk assessment selections including financial, business and trend analysis of data critical for decision making in achievement of business objectives.
- Prepares and may do presentations and reports.
- Periodically conduct cost/price analysis taking into account the combined effect of annual wage inflation, increases in claims cost arising from utilization/provider cost increases to determine appropriate level of premium for health care services.
- Continuously review risk factors in managed health care products and advise management appropriately.
- Review and evaluate all claims cost to ensure risks are kept within tolerable limits or mitigated.
- Provide professional input in the product design and development process
- Perform other related duties as may be assigned.
- Underwriter is the gatekeepers for healthcare insurances.
- BSc/MSc in Applied Mathematics, Actuarial Science, Statistics or Degree in Mathematics.
- At least 3 years’ experience and must have impressive tract records in conducting actuarial and risk analysis to develop pricing and new and exist g products I line with management’s and company’s objectives
- Strong analytical skills and adept interpreting strategic vision into an operational and tactical model for clear implementation.