Senior Actuarial Analyst / Associate Actuary

Job description

Position Summary This position may be filled as either a Senior Actuarial Analyst or Associate Actuary based on the selected candidate’s experience, SOA credentialing progress, technical expertise, and demonstrated scope of responsibility. In this role, you’ll apply actuarial and analytical expertise to evaluate healthcare and financial performance and support decisions across pricing, reserving, forecasting, provider reimbursement, product development, risk adjustment, and financial planning. You’ll develop actuarial models and projections, analyze complex healthcare data, and translate findings into meaningful insights and recommendations that help the business understand financial performance, evaluate risk, and make informed decisions. You’ll partner with leaders across Finance, Product, Clinical, Provider Network, Compliance, Underwriting, and other areas of the business. At the Senior Actuarial Analyst level, you’ll drive assigned analyses and develop actionable recommendations and insights. At the Associate Actuary level, you’ll take broader ownership of actuarial analyses and workstreams while serving as a growing technical authority and trusted actuarial resource to the business. Essential Job Functions In this role, you will: Perform complex actuarial analyses supporting pricing, reserving, forecasting, provider reimbursement, product development, risk adjustment, and financial planning to evaluate performance, quantify risk, and support business decisions. Develop, maintain, and enhance actuarial models and financial projections by analyzing claims experience, medical cost trends, utilization, membership, benefit changes, provider reimbursement, and other drivers of health plan performance. Translate actuarial analyses into actionable insights and recommendations by evaluating assumptions, alternative scenarios, financial impacts, emerging trends, and business risks. Partner with Finance, Product, Clinical, Provider Network, Compliance, Underwriting, and other stakeholders to evaluate business initiatives and provide actuarial expertise that supports operational and financial decision-making. Communicate actuarial findings and recommendations to business partners, clearly explaining methodologies, assumptions, financial implications, risks, and potential courses of action. Improve actuarial methodologies, models, reporting, and analytical processes through automation, enhanced tools, and process improvements that increase accuracy, efficiency, and decision-making capabilities. To be successful in this role, you must have: A bachelor’s degree or any equivalent combination of education, training, and experience. Minimum of two (2) years of actuarial experience. Successful completion of at least four (4) Society of Actuaries (SOA) examinations. Experience performing actuarial analyses within health insurance, managed care, healthcare consulting, or a related environment. Experience with one or more actuarial functions such as pricing, reserving, forecasting, medical cost analysis, provider reimbursement, risk adjustment, product development, or financial planning. Experience developing, maintaining, and validating actuarial models and working with large and complex healthcare or financial datasets. Strong analytical and problem-solving skills with demonstrated ability to interpret results, identify meaningful trends, and develop insights or recommendations. Advanced proficiency with Microsoft Excel and experience with SQL and/or analytical tools or programming languages used to analyze large datasets. Strong written and verbal communication skills with the ability to explain analytical findings and financial implications to technical and non-technical audiences. Ability to independently manage assigned work, balance multiple priorities, and collaborate effectively across functional areas. It would be great if you have: Experience with commercial health insurance, ACA Marketplace products, employer-sponsored coverage, or other health plan products. Experience with medical cost trend analysis, provider contracting or reimbursement, risk adjustment, benefit design, or healthcare financial forecasting. Experience with analytical programming or data visualization tools such as VBA, Python, R, SAS, Power BI, Tableau, or similar technologies. Experience with commercial health insurance rating, rate manuals, and rate algorithm tools like Optum StepWise. Benefits Automatic 4% employer contribution to retirement plan 401k plan with 100% match up to 6% Flexible time off for vacation, illness, etc. Nine paid holidays Day one health, Rx, vision, and dental insurance Life and disability insurance Flexible spending account Pet coverage and pet Rx discounts Free identity theft protection Free 2nd medical opinion service Location Texicare offers a flex-hybrid environment centered around collaboration and connection. All employees must reside in Texas. Team members living in the Austin area are expected to work from our office at least two days per week. Those based outside the greater Austin area may work remotely within Texas, with occasional travel to Austin as needed. Texicare is an equal opportunity employer. About Texicare Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas. Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare’s vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people’s lives. We’re looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas.