Health Insurance Actuary- Senior Associate

Health Insurance Actuary- Senior Associate

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Job Category People and Organisation Level Senior Associate Specialty/Competency Benefits Time Type Full time Travel Requirements Up to 40% Job ID 569222WD Location(s) US-Remote, CA-San Francisco, IL-Chicago, NY-New York

A career in our Benefits practice, within People and Organisation Consulting services, will provide you with the opportunity to help our clients reset their talent strategies and deliver extraordinary business results through their people. We focus on evaluating and managing their unique challenges so our clients can maximise their return on the overall investment in human capital. You’ll gain a tremendous depth of expertise in all aspects of human capital, including creating sustainable value through people culture and change, designing compensation and retirement strategies, and improving human capital operations. Our team helps our clients evaluate, redesign, implement and manage their health and welfare and retirement benefits programmes. You’ll help our clients with active and retiree plan performance management, vendor selection, provider strategy, financial reporting and cost driver analysis, private exchange and drug benefit evaluation.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As a Senior Associate, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

  • Use feedback and reflection to develop self awareness, personal strengths and address development areas.
  • Delegate to others to provide stretch opportunities, coaching them to deliver results.
  • Demonstrate critical thinking and the ability to bring order to unstructured problems.
  • Use a broad range of tools and techniques to extract insights from current industry or sector trends.
  • Review your work and that of others for quality, accuracy and relevance.
  • Know how and when to use tools available for a given situation and can explain the reasons for this choice.
  • Seek and embrace opportunities which give exposure to different situations, environments and perspectives.
  • Use straightforward communication, in a structured way, when influencing and connecting with others.
  • Able to read situations and modify behavior to build quality relationships.
  • Uphold the firm's code of ethics and business conduct.



As a PwC Healthcare Consulting Actuary, you will be part of our exciting, growing team that provides strategic, analytic, and technical support to our payer and provider clients. The healthcare sector continues to evolve, so our clients look to us to support them in redefining their strategy and thinking to maintain market share, margins, and achieve cost savings.

Job Requirements and Preferences:

Basic Qualifications:

Minimum Degree Required:
Bachelor Degree

Minimum Years of Experience:
3 year(s)

Preferred Qualifications:

Preferred Fields of Study:
Mathematical Statistics, Mathematics, Actuarial Science, Public Policy Analysis, Mathematical Economics, Finance

Certification(s) Preferred:

4+ Actuarial Exams

Preferred Knowledge/Skills:

Demonstrates thorough level abilities and a proven record of success as a team/functional contributor in the Payer and/or Provider industries, including:  

  • Contributing to projects involving actuarial aspects of commercial and government programs and issues in a major consulting firm or corporate environment, emphasizing areas that include pricing, underwriting, health plan financial reporting, data analysis, and risk adjustment;  
  • Helping companies define and evaluate corporate and business unit strategies and investment portfolios; and,  
  • Analyzing market, competitive, and other external drivers. 

Demonstrates thorough level abilities and a proven record of success in the following areas:  

  • Analyzing clients’ medical claim data to understand historical trends and suggest opportunities to implement savings initiatives;  
  • Writing medical cost and risk adjustment analytics using SAS to help clients identify sources of value;   
  • Analyzing a company’s financial statements finding opportunities to enhance their reporting;        
  • Supporting mergers and acquisitions by evaluating a target’s financial statements and developing a quality of earnings adjustment as well as providing insight into the target’s expected future earnings potential;  
  • Completing IBNR reserve analyses and assessing actuarial balances as part of year-end financial audits for health and life insurance companies; and, 
  • Researching business and industry trends to develop a point of view to leverage in assisting with proposals and opportunities across multiple lines of service.  

Demonstrates through level abilities and a proven record of success with automation & digitization in a professional services environment, including:  

  • Analyzing clients’ medical claim data to understand historical trends and suggest opportunities to implement savings initiatives;  
  • Evaluating a client’s end-to-end risk adjustment process, evaluating the return on investment for each operational activity and vendor;  
  • Supporting Value-Based Care contracting and analytics for payers, providers, and health services organizations;  
  • Developing predictive analytics to help identify gaps within a health plan’s coding procedures and optimize its revenue stream;  
  • Creating a strategic roadmap with clients entering a new line of business or market, including the development of a proforma;  
  • Innovating through new and existing technologies, along with experimenting with digitization solutions;  
  • Working with large, complex data sets to build models and leverage data visualization tools to provide insights to clients;  
  • Utilizing digitization tools to reduce hours and optimize engagements; and,  
  • Identifying alternative fee arrangements, including pricing tools, to provide a point of view on pricing strategies.

Learn more about how we work: https://pwc.to/how-we-work

PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.

All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines

The salary range for this position is: $84,000 - $202,000, plus individuals may be eligible for an annual discretionary bonus. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance

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Health Insurance Actuary- Senior Associate

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    PwC Recruiting: H-1B Lottery Policy

    PwC currently is not hiring experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth here.

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