Actuarial – Health Senior Manager – Commercial Pricing Level Funded

Location: Remote (preference hybrid in Atlanta, Boston, Chicago, Milwaukee, Philadelphia, San Francisco, Tampa, Washington DC)

The Health Practice of Oliver Wyman strives to be the consulting firm of choice for clients and employees, and to be recognized as the premier health actuarial consultancy by fostering the power of ideas to lead our industry, consistently helping clients achieve their strategic objectives, and gaining trusted advisor status. The practice seeks to inspire a team‑oriented culture which fosters free flowing ideas, values diversity, and allows for challenges to the status quo.

Its colleagues are proud to perform exciting, diverse, and leading‑edge work. Our vision is to discover what lies beyond the obvious, achieve breakthroughs for our clients, and persist as an industry leader. Our mission is to be the leader in the integration of actuarial science, data science, and information technology to solve our clients’ most demanding challenges. We combine traditional actuarial principles with non‑traditional solutions and communicate honestly and independently.

We believe that diverse perspectives and approaches are business imperatives, and these can only stem from a diverse group of people. Investing in our people and local communities while delivering unequaled value to our clients is core to our mission at Oliver Wyman.

As a Senior Manager, you will work alongside and learn from Oliver Wyman’s industry leaders and other consultants while contributing to a broad range of client projects. You will have significant interaction with Oliver Wyman’s clients, which include top tier insurance companies and regulatory agencies. You will be responsible for overseeing the workflow of projects, managing the completion of multiple work streams, and actively supporting the development of team members, contributing to their professional growth.

• Lead the development of pricing and rating processes for level‑funded and other group commercial health plans
• Health insurance product development, modeling, and analysis for the products in the commercial markets
• Set pricing assumptions, trends, and pricing methodologies
• Medical and pharmacy claims analysis, including benchmarking to applicable industry experience
• Feasibility studies for startup operations or expansions of new products for payers, providers, or payer‑provider partnerships
• Support of regulatory changes and implementation
• Evaluation of provider contracts and the impact of changes on rates
• Analysis of value‑based care and other risk‑taking arrangements from both the payer and provider perspectives
• Opportunity analyses for improved total‑cost‑of‑care management and population health
• Evaluation of risk scores and assistance with improving risk score coding/capture
• Evaluation of care management programs

• Bachelor’s or master’s degree, preferably in Actuarial Science, Mathematics, Statistics, Finance or a related field
• 7+ years of actuarial experience in the group commercial industry, with a preference for actuarial consulting, and specific experience working with level‑funded products
• Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) credentials
• Ability to demonstrate autonomy with minimal principal involvement while managing medium‑to‑large scale projects/work streams, generally with higher complexity
• A track record of, and desire for, rapid learning, high performance, and professional growth
• Strong written and oral communication skills
• Excellent time management skills
• Understanding of the value of collaboration and the ability to work effectively in a team setting
• Deep critical‑thinking skills and problem‑solving ability
• Highly motivated individual and willingness to work in a dynamic environment
• Strong skills with MS Excel, SAS, SQL, R, Python, VBA or other programming languages

The Actuarial Practice of Oliver Wyman seeks to invest in its people by fostering a safe and inclusive environment, respecting and welcoming different perspectives, promoting an ownership culture, providing opportunities for individuals to develop…