PwC

Health Insurance Actuary Manager

3 weeks agoNew York, NY / Remote

A career in our Benefits practice, within People and Organisation Consulting services, will provide you with the opportunity to help our clients reset their talent strategies and deliver extraordinary business results through their people. We focus on evaluating and managing their unique challenges so our clients can maximise their return on the overall investment in human capital. You'll gain a tremendous depth of expertise in all aspects of human capital, including creating sustainable value through people culture and change, designing compensation and retirement strategies, and improving human capital operations.Our team helps our clients evaluate, redesign, implement and manage their health and welfare and retirement benefits programmes. You'll help our clients with active and retiree plan performance management, vendor selection, provider strategy, financial reporting and cost driver analysis, private exchange and drug benefit evaluation.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As a Manager, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

  • Develop new skills outside of comfort zone.
  • Act to resolve issues which prevent the team working effectively.
  • Coach others, recognise their strengths, and encourage them to take ownership of their personal development.
  • Analyse complex ideas or proposals and build a range of meaningful recommendations.
  • Use multiple sources of information including broader stakeholder views to develop solutions and recommendations.
  • Address sub-standard work or work that does not meet firm's/client's expectations.
  • Use data and insights to inform conclusions and support decision-making.
  • Develop a point of view on key global trends, and how they impact clients.
  • Manage a variety of viewpoints to build consensus and create positive outcomes for all parties.
  • Simplify complex messages, highlighting and summarising key points.
  • Uphold the firm's code of ethics and business conduct.

As a PwC Healthcare Consulting Actuary, you will be part of our exciting growing team that provides strategic, analytic and technical support to our payer, provider & government clients (PPG) and our employer clients. The healthcare sector has fundamentally transformed over the last 5 years and as such, our clients look to us to support them in redefining their strategy and thinking to maintain market share, margins, and to achieve cost savings.

Job Requirements and Preferences:

Basic Qualifications:

Minimum Degree Required:
Bachelor Degree

Minimum Years of Experience:
5 year(s)

Preferred Qualifications:

Degree Preferred:
Master Degree

Preferred Fields of Study:
Actuarial Science, Mathematical Economics, Mathematics, Analytics, Public Policy Analysis, Economics, Finance, Mathematical Statistics, Statistics

Certification(s) Preferred:

ASA Designation

Preferred Knowledge/Skills:

Demonstrates extensive abilities and/or a proven record of success in roles leading functions or projects involving actuarial aspects of commercial and government programs and issues in a major consulting firm or corporate environment, emphasizing areas that include pricing/underwriting, health plan financial reporting, data analysis, and risk adjustment.

Demonstrates extensive abilities and/or a proven record of success of the Payer or Provider industries including knowledge of and/or success in professional services or corporate roles, helping companies define and evaluate corporate and business unit strategies and investment portfolios, reflectingDemonstrates extensive abilities and/or a proven record of success market, competitive and other external drivers.

Demonstrates extensive knowledge of, and/or proven record of success with:

  • Managing multiple projects and deadlines;
  • Working with management and senior level executives at other organizations;
  • Understanding alternative fee arrangements, including the use of pricing tools, to provide a point of view on pricing strategies;
  • Understanding actuarial aspects of commercial and government healthcare programs;
  • Helping identify client issues and resources needed to solve problems;
  • Using analytical thinking skills to evaluate analyses for communication to clients;
  • Analyzing clients medical claim data to understand historical trends and suggest opportunities to implement savings initiatives;
  • Evaluating a client's end-to-end risk adjustment process, evaluating the return on investment for each operational activity and vendor;
  • Developing predictive analytics to help identify gaps within a health plan's coding procedures and optimizing their revenue stream;
  • Creating a strategic roadmap with clients entering a new line of business or market, including the development of a proforma;
  • Analyzing a company's financial statements finding opportunities to enhance their reporting or allocation of administrative expenses;
  • Supporting payers and providers as they move down the value based care continuum, identifying impacts to their cost structure and operations;
  • Supporting mergers and acquisitions by evaluating a target's financial statements and developing a quality of earnings adjustment as well as providing insight into the target's expected future earnings potential;
  • Developing and utilizing pricing models to help clients forecast earnings, budgets and pro-formas as well as certify rate filings;
  • Completing IBNR reserve analyses and assess actuarial balances as part of year-end financial audit for health and life insurance companies;
  • Researching business and industry trends to develop a point of view to leverage in assisting with proposals, considering opportunities across multiple lines of service;
  • Innovating through new and existing technologies, along with experimenting with digitization solutions;
  • Working with large, complex data sets to build models and leverage data visualization tools to provide insights to clients;
  • Working independently and within a team; and,
  • Being client focused and results oriented.

At PwC, our work model includes three ways of working: virtual, in-person, and flex (a hybrid of in-person and virtual). Visit the following link to learn more: https://pwc.to/ways-we-work.

PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.

All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

For positions in Colorado, visit the following link for information related to Colorado's Equal Pay for Equal Work Act: https://pwc.to/coloradoadvisorymanager. 339749 339749WD

#LI-Remote

Client-provided location(s): New York, NY, USA; Chicago, IL, USA
Job ID: PricewaterhouseCoopers-339749WD

Perks and Benefits

  • Professional Development
    • Access to Online Courses
    • Shadowing Opportunities
    • Mentor Program
    • Promote From Within
    • Learning and Development Stipend
    • Tuition Reimbursement
  • Vacation and Time Off
    • Leave of Absence
    • Sabbatical
    • Personal/Sick Days
    • Paid Holidays
    • Paid Vacation
    • Paid Family Leave
  • Office Life and Perks
    • Commuter Benefits Program
    • Remote Work Opportunities
    • Flexible Work Hours
    • Company Outings
    • Some Meals Provided
    • Snacks
    • Happy Hours
    • Casual Dress
    • Diversity, Equity, and Inclusion Program
  • Health and Wellness
    • Fitness Subsidies
    • Wellness Program
    • HSA With Employer Contribution
    • Long-Term Disability
    • Short-Term Disability
    • Life Insurance
    • Vision Insurance
    • Dental Insurance
    • Health Insurance
    • HSA
    • FSA
  • Financial and Retirement
    • Relocation Assistance
    • Performance Bonus
    • 401(K) With Company Matching
    • 401(K)