Medical and Pharmacy Actuarial Assistant

#LI-CM #LI-Remote

The position will include financial assessments of employee benefits, forecasting health care benefit costs, forecasting health care actuarial reserves, predictive modeling, data analytics, and forecasting the economic impact of the health care reform.

Essential Functions and Primary Duties:

• Risk Assessment & Underwriting

• Review and analyze medical and pharmacy claims experience, demographic data, and plan design details to assess risk.

• Develop and deliver accurate renewal calculations, new business quotes, and stop-loss evaluations.

• Collaborate with sales, account management, and product teams to develop competitive pricing strategies.

• Actuarial Analysis

• Build, refine, and maintain actuarial models to support pricing and forecasting efforts.

• Monitor emerging healthcare and pharmacy trends to incorporate into underwriting assumptions.

• Conduct experience studies and recommend adjustments to rating assumptions as needed.

• Financial Performance & Reporting

• Provide insight into book-of-business performance, loss ratios, and trend development.

• Prepare and present analyses to internal stakeholders and senior leadership.

• Support financial forecasting and budget-setting initiatives.

• Collaboration & Compliance

• Partner with compliance and regulatory teams to ensure adherence to state and federal requirements.

• Act as a subject-matter expert on risk, pricing methodology, and market competitiveness.

Preferred Qualifications:

• Bachelor's degree in Actuarial Science, Economics, Statistics, or other math-oriented degrees

• One or more years of underwriting and/or actuarial healthcare experience

• Two or more actuarial exams passed

• Must possess analytical skills (mathematics and statistics)

• Must be able to comprehend, manipulate, and interpret statistical data

• Demonstrated ability to communicate verbally and in writing throughout all levels of organization, both internally and externally

• Proficient use of applicable software, in particular, MS Office, Excel, Outlook, Access, VBA, SQL, M, and SAS