Seeking a Senior Commercial Health Actuary / Underwriter with deep group health insurance expertise to join our clients team as a high-level individual contributor. This is a mix of a technical role that blends actuarial pricing rigor with hands-on underwriting judgment, supporting group health insurance product lines. The ideal candidate has spent significant time on both sides of the house - building rates and developing models and underwriting complex group cases - and can operate independently as a subject matter expert across the commercial group business.
Key Responsibilities
Actuarial / Pricing
• Develop, maintain, and refine manual rates, trend assumptions, and pricing models for fully insured and level-funded group medical products across small group, mid-market, and large group segments.
• Lead experience studies, IBNR analyses, and loss ratio reviews to inform pricing adequacy and reserve sufficiency.
• Partner with product, finance, and reinsurance teams on rate filings, pricing, and regulatory submissions across multiple states.
• Build and enhance predictive models and risk scoring tools to improve case-level pricing accuracy and portfolio profitability.
Underwriting
• Underwrite complex group cases
• Evaluate census data, claims experience, demographics, plan design, and stop-loss exposure to render final rate and risk decisions.
• Provide technical guidance and case-level review for junior underwriters; serve as an escalation point for non-standard or high-exposure quotes.
• Partner with sales, broker, and account management teams on renewal strategy, alternative funding options, and competitive positioning.
Strategic / Cross-Functional
• Act as a bridge between Actuarial and Underwriting, ensuring pricing assumptions reflect real-world underwriting outcomes and vice versa.
• Identify trends in block performance, persistency, and competitive positioning; recommend pricing or guideline adjustments.
• Support leadership on strategic initiatives including new product development, market entry, M&A diligence, and reinsurance/stop-loss negotiations.
Qualifications
Required
• 6+ years of combined commercial group health experience spanning both actuarial pricing and underwriting functions.
• Experience in fully insured and self-funded / level-funded group medical products; familiarity with ancillary lines (dental, vision, life, disability) a plus.
• Strong command of manual rating, experience rating, trend analysis, IBNR, and stop-loss pricing.
• Demonstrated ability to underwrite mid-market and large group cases independently.
• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related quantitative field.
• ASA or FSA designation strongly preferred; MAAA a plus. Non-credentialed candidates with extensive equivalent experience will be considered.
• Proficiency in SQL, Excel, and at least one analytical language (R, Python, SAS, or VBA).
Desired Skills and Experience
Group Heakth Inurance, Actuarial, Underwriting, ASA, Commercial Health