Health Actuary

at  Health Solutions

INTRODUCTION

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.

REQUIREMENTS

• Matric
• Bachelor’s Degree in Actuarial Science
• Qualified or nearly Actuary
• MS SQL programming skills
• 2 –; 3 year’s post actuarial qualification experience
• 2 –; 3 years’ experience in managed care, health risk management health; Service/ product pricing or scheme benefit design
• 2 - 3 years’ experience in the South African Medical Scheme industry.
• Experience in working with MS Word, MS Excel (Macro Level) and MS Access

ROLE PURPOSE

The purpose of this role is to support the Corporate Medical Schemes Business Unit by operating within a best practice framework for the Actuarial function, which includes:

• Managing and developing a team of actuarial analysts.
• Forming part of the leadership in the business unit and carrying out duties as required by the Low-income healthcare Business Unit Exco.
• Representing the company as a client-facing ambassador.
• Ensuring growth of the business in the target market by demonstrating our integrated value proposition to clients.
• Developing a comprehensive range of optimally bundled, fit for purpose and best in class bundled product solutions and client services.
• Offering benefit design thought leadership by working in unison with each clients’ clinical executive, fund manager and representative from the provider team.

DUTIES & RESPONSIBILITIES

• Actuarial Analysis, Modelling and Reporting.
• Oversee and review the following as delivered by the team of actuarial analyst, and present to clients.
• Collect data from relevant sources and perform actuarial analysis as required.
• Conducting risk data analysis, and direct clinical risk management strategies.
• Risk management reporting and health informatics.
• Benefit design, product pricing and predictive modelling.
• Provide the necessary input towards improvement of existing models and processes.
• IBNR calculation and reporting.
• Support for tariff negotiations, including development of models to assess impacts tariff increases.
• Demonstrate a basic understanding of the regulatory and commercial framework in which he or she operates.
• Communicate actuarial modelling, analyses and investigations to relevant stakeholders clearly and concisely.
• Enable client centricity within area of responsibility.