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Texicare · 7 hours ago

Lead Actuary / Senior Lead Actuary

Texas, United States

Full-time

Hybrid

Senior Level, Lead/Staff

8+ years exp

Texicare is a mission-driven health affiliate of Texas Mutual, headquartered in Austin, Texas, focused on transforming the healthcare landscape for small businesses. The Lead Actuary will support company strategy by managing actuarial expertise and delivering key membership and financial results in collaboration with various teams and partners.

Financial ServicesHealth InsuranceInsurance

No H1B

Responsibilities

Monitoring:

Claims trends and investigating aberrations

On-going analysis and monitoring of utilization trends

Analyzing data and communicating results in data visualizations, dashboards, and reports for a wide variety of audiences

FP&A and Budgeting:

Support Health Plan budgeting, forecasting, and strategic planning activities in partnership with the Enterprise

Strategy and Corporate FP&A teams

Analyze customer data to provide insights on overall performance, define targets for KPIs, and track progress against targets

Pricing and Actuarial Oversight:

Oversee pricing of multiple commercial health products

Seek out external resources to help understand macro drivers of trend

Direct the development of actuarial models, analyses, and projections to support product pricing, rate filings, network contracting including innovative value-based reimbursement strategies, and cost management

Strategic Leadership:

Develop and implement the organization’s actuarial strategy aligned with business objectives and regulatory requirements

Provide expert guidance to the executive team and board of directors on actuarial matters, including pricing, risk management, and financial planning

Risk Management:

Oversee the assessment and mitigation of financial and operational risks related to health insurance products and services

Provide actuarial insights to support enterprise risk management and business resilience initiatives

Regulatory Compliance:

Ensure compliance with all relevant regulations, including rate filings, solvency standards, and actuarial certifications

Serve as a liaison with regulatory bodies and represent the organization during audits and reviews

Leadership & Management

Strong experience in team management, project oversight, and mentoring junior staff

Promote diversity, equity, and inclusion within the team and across the organization, fostering a culture of innovation, collaboration, and professional growth

Qualification

Actuarial methodologiesData analyticsPricing oversightRisk managementRegulatory complianceMicrosoft OfficeTableauCommunication skillsTeam managementNegotiation skillsProblem-solving skills

Required

A bachelor's degree or any equivalent combination of education, training, and experience

At least 8 years of actuarial experience in a healthcare setting or any equivalent combination of education, training, and experience

Exceptional ability to communicate (oral, written, presentation) complex actuarial concepts and engage with various stakeholders, including health plan partners, other leaders and board of directors

Strong skills in collaborative working environment

Self-starter with an innate desire to learn and the ability to thrive in a dynamic fast-paced start-up environment with competing priorities and deadlines with the strong backing of an established company

Experience leading negotiations for multi-million-dollar contracts

Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint

Experience with Tableau, statistical analysis and predictive modeling in healthcare contexts

Strong analytical, quantitative, problem-solving, and business skills to extract implicit, unstated, and unrecognized requirements