Job Title: Senior Actuarial Analyst

Location:

Tshwane Metro, Pretoria, Brooklyn

Permanent, Full-Time

Health, Medical and related

Insurance

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

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