Key Responsibilities
- Build pricing and underwriting models and analyses to guide new deal pricing and review of existing pricing arrangements
- Perform detailed medical cost, utilization, and trend analyses to support rate development and pricing recommendations.
- Evaluate profitability of quotes, renewals, and book-level performance relative to pricing assumptions.
- Track performance of existing contracts
- Support evaluation of risk and pricing strategies for new and existing products through multiple scenarios, such as base, downside and upside cases.
- Analyze and assess the integrity of the data being used for underwriting. Identify and recommend mechanisms and contract terms that mitigate known and unknown risks and uncertainties.
- Partner with operations, medical economics / business analytics, product, sales, account management and others as appropriate, including providing guidance during the proposal, diligence and contracting phases regarding data and analytics requirements to ensure strong underwriting can be achieved, along with maximizing outcomes and minimizing risk.
- Maintain data integrity and accuracy in pricing and underwriting databases.
- Perform additional duties as assigned
Qualifications:
- Bachelor’s degree in Finance, Economics, Mathematics, Actuarial Science, Statistics, or a related field.
- At least 10 years of experience in underwriting or pricing within a health plan
- Experience in healthcare, value-based care, or insurance industries, M&A and private equity are a plus.
Preferred Qualifications:
- Experience working in private equity-backed organizations.
- Prior exposure building and presenting materials to boards and executives.
Technical Expertise:
- High proficiency in financial and analytical modeling
- Advanced Excel and PowerPoint skills; experience with data visualization tools (e.g., Power BI) is a plus.
- Understanding of financial statements, health care data, and performance management metrics.
Personal Attributes:
- Strong analytical mindset with intellectual curiosity and a passion for problem-solving.
- Excellent attention to detail, an exceptionally high degree of initiative and adaptability, and the ability to multitask in a high-pressure environment with numerous conflicting deadlines.
- Sharp, hardworking, and capable of quickly noticing issues, trends, or opportunities.
- Able to work upwards (to CEO, CFO, Private Equity Partners, Board of Directors) and across the business (interdepartmental, customers, vendors, etc.); can “see around the corners” to add value to the business and be a strong strategic thinker.
- High integrity, professionalism, and collaborative approach.
- Adaptable and proactive, with the ability to navigate ambiguity and prioritize effectively.
- Excellent verbal and written communication skills.
- Advanced Excel and analytical tool skills; experience with data visualization tools (e.g., Power BI) is a plus.
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