Health Actuary

About the role

The Health Actuary is responsible for performing actuarial analysis, owning actuarial models, evaluating the financial impact of benefit enrollment, funding, and healthcare cost changes, and providing recommendations to stakeholders.

Responsibilities

• Owns actuarial models, key analyses, assumptions, and recurring deliverables for assigned health actuarial workstreams.
• Performs actuarial valuations, forecasting, experience studies, trend analyses, utilization studies, and financial impact assessments.
• Develops, validates, and enhances actuarial models used to evaluate healthcare costs, enrollment projections, benefit changes, and funding requirements.
• Performs sensitivity testing and scenario analysis to quantify financial risks and evaluate alternative strategies.
• Reviews data sources, identifies anomalies, and ensures the completeness, accuracy, and reliability of actuarial analyses.
• Documents model methodologies, assumptions, processes, limitations, and results to support transparency and auditability.
• Refines assumptions, run scenarios, interpret model results, and document methods, rationale, limitations, and impacts.
• Develops rates for self-funded active and retired populations.
• Determines the impact of plan design and benefit changes on enrollment, utilization, and health care costs.
• Prepares statutory and legislative reports related to health care benefit programs.
• Develops data for reporting and analysis for all TRS health benefit programs.
• Analyzes data to identify emerging trends.
• Maintains and updates IBNR models.
• Researches benefit costs and suggests ways of controlling health care spending.
• Develops reports to help monitor the status of Accountable Care Organizations, value-based arrangements and other TRS initiatives.
• Reviews actuarial work performed by others.
• Develops and updates financial models to evaluate the value of proposals for TRS-Care and TRS-ActiveCare services.
• Assists with the development of fund balance projections for TRS-Care and TRS-ActiveCare.
• Reviews and analyzes statistical and financial reports, including reports reflecting vendor credits, rebates and refunds expected and received; and reports monitoring the financial status of TRS-Care and TRS-ActiveCare.
• Develops financial models to evaluate the value of proposals for TRS-Care and TRS-ActiveCare services.
• Provides actuarial expertise to management regarding financial risks, program design alternatives, and policy decisions.
• Develops recommendations and presents analytical findings, assumptions, risks, and alternatives to stakeholders.
• Translates complex actuarial concepts into understandable business information for non-technical audiences.
• Serves as a subject matter resource on assigned actuarial projects.
• Supports decision-making through quantitative analysis and evidence-based recommendations.

Requirements

• Bachelor’s degree from an accredited college or university in actuarial science, finance, mathematics, economics, statistics or related field.
• Three (3) years of progressively responsible actuarial experience involving modeling, forecasting, financial analysis, risk assessment or related experience.
• Associate of the Society of Actuaries (ASA) designation earned.

Qualifications

• Advanced degree in actuarial science, accounting, finance, mathematics, statistics, economics, or a related field.
• Experience in using statistical software, tools, and databases.
• Four (4) years of experience in the healthcare industry, insurance industry or employee benefits administration, especially with large group plans.
• Knowledge of Principles, practices, and techniques associated with actuarial services, health insurance administration, and general accounting and auditing.
• Skills in Researching, compiling and analyzing complex data, including querying a claim data warehouse.
• Completing detailed work with a high degree of accuracy.
• Written and verbal communications, including drafting and delivering complex correspondence, reports, presentations, and proposals.
• Utilizing a personal computer and various business software programs including Microsoft Word, Excel, and Outlook; including using spreadsheets for data analysis and presentation.
• Ability to Think critically, analyze problems, evaluate alternatives, and recommend effective solutions.
• Meet frequent and multiple deadlines, manage conflicting priorities and demands, and adapt to changes in schedules and assignments.
• Establish and maintain harmonious working relationships with co-workers, agency staff, vendors and other external contacts and to work effectively in a professional team environment.

Preferred Qualifications

• Veterans, Reservists or Guardsmen with experience in the Military Occupational Specialty ( https://www.trs.texas.gov/files/trs-military-crosswalk.xlsx ) along with the minimum qualifications listed above may meet the minimum requirements and are highly encouraged to apply.