Senior Actuarial Analyst / Associate Actuary

Summary

Texicare is a mission-driven health affiliate focused on providing innovative, affordable healthcare solutions for small businesses and Texans. The Senior Actuarial Analyst / Associate Actuary will evaluate healthcare and financial performance through actuarial analyses, models, and projections supporting pricing, reserving, forecasting, provider reimbursement, product development, risk adjustment, and financial planning. The role will partner with cross-functional stakeholders to translate findings into actionable business recommendations.

Responsibilities

• Perform complex actuarial analyses supporting pricing, reserving, forecasting, provider reimbursement, product development, risk adjustment, and financial planning to evaluate performance, quantify risk, and support business decisions
• Develop, maintain, and enhance actuarial models and financial projections by analyzing claims experience, medical cost trends, utilization, membership, benefit changes, provider reimbursement, and other drivers of health plan performance
• Translate actuarial analyses into actionable insights and recommendations by evaluating assumptions, alternative scenarios, financial impacts, emerging trends, and business risks
• Partner with Finance, Product, Clinical, Provider Network, Compliance, Underwriting, and other stakeholders to evaluate business initiatives and provide actuarial expertise that supports operational and financial decision-making
• Communicate actuarial findings and recommendations to business partners, clearly explaining methodologies, assumptions, financial implications, risks, and potential courses of action
• Improve actuarial methodologies, models, reporting, and analytical processes through automation, enhanced tools, and process improvements that increase accuracy, efficiency, and decision-making capabilities

Skills

• A bachelor's degree or any equivalent combination of education, training, and experience
• Minimum of two (2) years of actuarial experience
• Successful completion of at least four (4) Society of Actuaries (SOA) examinations
• Experience performing actuarial analyses within health insurance, managed care, healthcare consulting, or a related environment
• Experience with one or more actuarial functions such as pricing, reserving, forecasting, medical cost analysis, provider reimbursement, risk adjustment, product development, or financial planning
• Experience developing, maintaining, and validating actuarial models and working with large and complex healthcare or financial datasets
• Strong analytical and problem-solving skills with demonstrated ability to interpret results, identify meaningful trends, and develop insights or recommendations
• Advanced proficiency with Microsoft Excel and experience with SQL and/or analytical tools or programming languages used to analyze large datasets
• Strong written and verbal communication skills with the ability to explain analytical findings and financial implications to technical and non-technical audiences
• Ability to independently manage assigned work, balance multiple priorities, and collaborate effectively across functional areas
• All employees must reside in Texas
• Experience with commercial health insurance, ACA Marketplace products, employer-sponsored coverage, or other health plan products
• Experience with medical cost trend analysis, provider contracting or reimbursement, risk adjustment, benefit design, or healthcare financial forecasting
• Experience with analytical programming or data visualization tools such as VBA, Python, R, SAS, Power BI, Tableau, or similar technologies
• Experience with commercial health insurance rating, rate manuals, and rate algorithm tools like Optum StepWise

Qualifications

Must Haves

• A bachelor's degree or any equivalent combination of education, training, and experience
• Minimum of two (2) years of actuarial experience
• Successful completion of at least four (4) Society of Actuaries (SOA) examinations
• Experience performing actuarial analyses within health insurance, managed care, healthcare consulting, or a related environment
• Experience with one or more actuarial functions such as pricing, reserving, forecasting, medical cost analysis, provider reimbursement, risk adjustment, product development, or financial planning
• Experience developing, maintaining, and validating actuarial models and working with large and complex healthcare or financial datasets
• Strong analytical and problem-solving skills with demonstrated ability to interpret results, identify meaningful trends, and develop insights or recommendations
• Advanced proficiency with Microsoft Excel and experience with SQL and/or analytical tools or programming languages used to analyze large datasets
• Strong written and verbal communication skills with the ability to explain analytical findings and financial implications to technical and non-technical audiences
• Ability to independently manage assigned work, balance multiple priorities, and collaborate effectively across functional areas
• All employees must reside in Texas

Nice to Haves

• Experience with commercial health insurance, ACA Marketplace products, employer-sponsored coverage, or other health plan products
• Experience with medical cost trend analysis, provider contracting or reimbursement, risk adjustment, benefit design, or healthcare financial forecasting
• Experience with analytical programming or data visualization tools such as VBA, Python, R, SAS, Power BI, Tableau, or similar technologies
• Experience with commercial health insurance rating, rate manuals, and rate algorithm tools like Optum StepWise

Benefits

• Automatic 4% employer contribution to retirement plan
• 401k plan with 100% match up to 6%
• Flexible time off for vacation, illness, etc.
• Nine paid holidays
• Day one health, Rx, vision, and dental insurance
• Life and disability insurance
• Flexible spending account
• Pet coverage and pet Rx discounts
• Free identity theft protection
• Free 2nd medical opinion service
• Flex-hybrid environment: employees living in the Austin area are expected to work from the office at least two days per week; those based outside the greater Austin area may work remotely within Texas, with occasional travel to Austin as needed