Medical Analytics and Pricing Manager

Data Management

• Ownership of Data Take ownership of data including its collection, storage, updates, and governance.
• Data Quality perform periodic validity checks to ensure the data used in all work is complete, reasonable, and accurate

• Portfolio Analysis perform members wise, policy wise, sector wise and different classification wise profitability report to help management understand the source of profit and further actions.

Perform overall portfolio analysis, including analysis of provider behavior through claims data analytics and produce regular performance reports and dashboards. These reports should support decision-making and use in UW, pricing, claims, network, cost control and FWA functions

• Support Functions Analysis
  :
  Drive service delivery and member experience enhancements from analytics and work with function leaders to incorporate and rollout improvements.
• Risk detection and reporting
  :
  Be able to inform and report any or all risks arising from the business, whether current or emerging, and be able to recommend mitigation factors

• Pricing Model Improvement
  :
  Improve Corporate and Small and Medium Enterprise (SME) pricing models, including regular tasks like pricing revisions, performance monitoring, and performance reporting.

Use sophisticated pricing methodology to determine base rates and gross rates including but not limited to bootstrapping, GLM, regression, time series, chain methods etc

• Underwriting Practice Enhancement
  :
  Help improve underwriting practices by introducing standard and efficient pricing procedures for use by the underwriting team.
• Tool Development Support
  :
  Work closely with the actuarial and underwriting team to support the development and implementation of pricing tools for corporate business.
• Expense calculations

Use expense studies and calculate loss ratios to determine combined ratios for clients

Design new product/ recommend changes on the current product’s feature to improve sales and increase profitability

• Appointed Actuary
  :
  Work closely with the Appointed Actuary and internal actuarial function to manage the provision of required data, information and analysis so that the actuarial deliverables are met with acceptable quality.
• Walaa Strategy
  :
  Contribute effectively towards creating and executing and effective medium to long term strategy of the Medical business of Walaa.

• Internal Processes Optimization
  :
  Work to improve internal processes and systems based on the outcomes of analysis and reports.
• Methodology Updates
  :
  Ensure capturing of recent pricing methodologies adapted in the Saudi market and support improving pricing efficiency by exploring new pricing factors and new discount elements.

• Profitability Initiatives
  :
  Recommend initiatives to enhance profitability for all business lines of Medical.
• Distribution Channel Monitoring
  :
  Provide support in monitoring the performance of all distribution channels and report any irregularities that arise.

• Bachelor Degree in Data science, Actuarial Science, Applied Mathematics or similar major.

• 5 Years of expertise.

• Excellent quantitative, analytical, and problem-solving skills.
• Superior to excellent communication, interpersonal and organizational skills.
• High degree of self-motivation and creative problem solving.

• Knowledge of Microsoft Products (Excel, Access, VBA).
• Knowledge of SQL/Python/R/Tableau, or desire to learn.