Graduate of Bachelor's Degree in Actuarial Science, Applied Mathematics or Statistics; License is required.
Must have passed at least 4 actuarial examinations or any related actuarial accreditation examination.
Minimum of 6 years experience and must have impressive and solid track record in conducting actuarial and risk analysis used to develop pricing for new and existing products in line with management's and company's objectives, gathering and preparing analysis based on information from internal and external sources.
Must have the capability to initiate, organize and manage actuarial/underwriting projects independently. Also responsible for conducting research health care cost trends and applying actuarial analysis and techniques to arrive at recommended ways to reduce health care costs.
Must also have very strong background in applied knowledge of mathematics, probability, statistics, principles of finance and business to problems in insurance.
Strong managerial competencies in the areas of leadership and team development, coaching and mentoring and situational assessment skills and with proven track record in building and developing high performing teams.
A change agent and capable of guiding the team in initiating various change management initiatives with the view of leading and guiding the organization towards the future.
Strong managerial acumen in setting team directions and aligning team goals around business plans.
Superior judgment, negotiation and decision-making skills.
Strong ethics and a high level of personal and professional integrity.
Strong analytical skills and adept in interpreting strategic vision into an operational and tactical model.
An effective communicator with strong oral, written and persuasive skills and capability to deal with people at all levels in the organization.
Knowledgeable of federal and state laws and requirements relating to healthcare management.
Computer literate and very highly proficient in using MS office programs.

Job Summary

Reports directly to the Health Plan Administrator and responsible for providing ongoing technical and analytical support to Pricing and Underwriting department. Responsible for actuarial and risk analysis used to develop pricing for new and existing products in alignment with management and company's objectives. Initiate, organize and manage actuarial and underwriting related projects and strategies independently. Responsible for researching health care cost trends and applying actuarial analysis and techniques to arrive at recommended ways to reduce health care costs. Oversee and responsible for all Actuarial and Underwriting functions relating to medical, dental, life and other insurance products.

Duties And Responsibilities

Actuarial and Underwriting Functions

1.1. Gathers and prepares analysis based on information from internal and external sources.

1.2. Applies knowledge of mathematics, probability, statistics, principles of finance and business to problems in insurance.

1.3. Research functional issues using a variety of resources. Develops/prepares reports and assists in the development of new/revised policies.

1.4. Interprets government regulations and internal policies. Participates in preparation of documentation related to government filings/licensing.

1.5. Assists in the administration of assigned programs. Develops, maintains, audits and reviews functional databases and identifies inconsistencies.

1.6. Prepares recommendations based on data summaries, trend analysis, financial analysis, and business analysis.

1.7. Analyzes data, constructs probability tables to forecast risk and liability for future payment benefits.

1.8. Ascertains premium rates and cash revenues to ensure payment of future benefits.

1.9. Reviews, analyzes, and approves ratings for new and renewing large commercial groups.

1.10. Reviews, analyzes, and approves Community Rating by Class (CRC) and Adjusted Community Rating (ACR) rate development models.

1.11. Reviews, analyzes, and approves pricing and rating models, trends and assumptions.

1.12. Assists in Federal and Postal program proposal, reconciliation and audit process and documentation.

1.13. Reviews and approves ratings for large commercial employer groups.

1.14. Oversees and formulates the company's risk management strategies.

1.15. Assists in product development activities and ensures timely and accurate Actuarial support on product development related programs and initiatives.

1.16. Oversee and manages the job responsibilities, work output and performance of Actuarial and Underwriting staff.

1.17. Monitors, tracks and ensures the attainment of department goals and objectives.

1.18. Provides underwriting analysis for pricing and risk assessment selections including financial, business, and trend analysis of data critical for decision making in achievement of business objectives.

1.19. Prepares and may do presentations.

1.20. Participates in cross-functional teams to develop new/enhanced systems/processes/programs/policies to support business needs.

1.21. Performs other duties that may be assigned from time to time.

General Management

2.1. Planning

2.1.1. Develops strategic plans and programs for Pricing & Underwriting and ensures that goals and objectives of the team are properly defined and clearly established.

2.1.2. Develops policies, guidelines, and implementing procedures and ensures consistent company-wide implementation.

2.1.3. Develops budgetary plans, programs, and guidelines to ensure the team's strict adherence with financial guidelines and requirements.

2.1.4. Ensures that operating expenses are well within the prescribed limits of budget plans and fiscal guidelines.

2.2. Organizing

2.2.1. Designs and develops the appropriate organization structure for the Pricing & Underwriting team.

2.2.2. Delineates, defines, and streamlines its various functional activities, thereby ensure its effectiveness in maximizing the utilization of both asset and people resources.

2.3. Leading

2.3.1. Performs Selection And Staffing Functions Such As

2.3.1.1.In collaboration with Human Resources Department and Health Plan Administrator, conducts in-depth assessment interviews to determine the technical and behavioral competencies of the candidate to ensure that the best from among the qualified candidates are being hired in the company.

2.3.1.2.Adheres to, and implements the philosophy of hiring the best fit and ensures that prospective employees personal values are aligned with the company's corporate values.

2.3.2. Conducts regular and periodic meetings with the team, to ensure the following:

2.3.2.1. Implementation of all Pricing & Underwriting plans, programs, and projects are strictly adhering to prescribed deadlines and schedules.

2.3.2.2.All communications and relevant information pertaining to the team are cascaded to the proper channels within the team in particular, and the organization in general.

2.3.3. Conducts and implements Performance Improvement Program, through the following:

2.3.3.1.Performance coaching for the staff who failed to perform and deliver the prescribed and committed level of performance output and standards.

2.3.3.2.Performance counseling staff with behavioral/attitudinal problems. Implements the necessary guidelines on discipline management for erring employees, in accordance with company policies, rules and regulations, due process, and government regulations.

2.3.3.3.Performance mentoring for high potential staff, capable of assuming bigger responsibilities in the future.

2.3.4. Performs Training And Development Functions, As Follows

2.3.4.1.Designs and develops training programs that are relevant and necessary for the continuous development of the technical competencies of the team.

2.3.4.2.Recommends and implements for appropriate training programs that will further enhance and hone the technical competencies of the staff.

2.3.4.3.Conducts training programs, and acts as subject matter expert on training programs pertaining to Pricing & Underwriting Philippine team.

2.4. Controlling

2.4.1. Develops and formulates performance measures and standards for the team, as basis for the conduct of annual performance management review program.

2.4.2. Reviews and evaluates the performance of the team, on regular and periodic basis, and ensures that the overall performance of the team is on-track, and well within the pre-established goals and objectives.

2.4.3. Consolidates performance status reports of the team as basis for monitoring the weekly progress of the various activities within the team.

Actuarial and Underwriting Manager