Analytics and Pricing Manager

Key Responsibilities:

1. Data Management and Governance

• Take ownership of health pricing and portfolio analytics data, including data collection, validation, storage, updating, reconciliation, and governance.
• Ensure data used for pricing, underwriting, renewal analysis, claims analytics, and management reporting is complete, accurate, reasonable, and fit for purpose.
• Work with IT, operations, claims, finance, underwriting, and actuarial teams to improve data quality, data availability, and reporting consistency.
• Maintain structured datasets for Corporate and SME health portfolios, including member-level, policy-level, claims-level, provider-level, benefit-level, segment-level, and distribution-channel-level data.
• Identify data gaps, inconsistencies, or process weaknesses that may affect pricing accuracy, profitability analysis, or regulatory/actuarial reporting.

2. Portfolio Analytics and Profitability Reporting

• Perform regular portfolio analysis for the Corporate and SME health portfolios, including profitability by client, policy, member segment, sector, geography, benefit structure, provider network, broker/channel, and other relevant classifications.
• Produce loss ratio, combined ratio, claims trend, frequency, severity, utilization, medical inflation, and claims development analysis.
• Develop regular management reports and dashboards to support decision-making across underwriting, pricing, claims, network, cost control, distribution, and senior management.
• Analyze provider behavior through claims data, including high-cost providers, abnormal utilization patterns, tariff impact, benefit abuse indicators, and cost escalation drivers.
• Identify current and emerging portfolio risks and recommend practical mitigation actions.
• Support management in understanding the source of profit or loss and the corrective actions required at portfolio, segment, client, or product level.

3. Pricing Model Development and Improvement

• Support the development, enhancement, and maintenance of pricing models for Corporate and SME health business.
• Improve pricing methodologies for new business, renewals, SME pricing models, experience-rated business, and portfolio pricing assumptions.
• Review and update base rates, gross rates, loadings, discounts, margins, medical inflation assumptions, expense assumptions, and risk adjustment factors.
• Support periodic pricing revisions based on portfolio performance, claims experience, provider cost trends, benefit utilization, regulatory changes, and market developments.
• Ensure pricing tools are structured, controlled, documented, tested, and suitable for use by underwriting and pricing teams

4. Underwriting and Renewal Pricing Support

• Provide actuarial and analytical support to the underwriting team for Corporate and SME new business and renewals.
• Support renewal pricing through experience analysis, claims projection, burning-cost analysis, trend loading, benefit adjustment, risk margin assessment, and profitability review.
• Recommend pricing actions for poorly performing clients, segments, sectors, channels, or product variants.
• Help improve underwriting practices by introducing consistent pricing procedures, pricing templates, technical guidelines, and risk assessment approaches.
• Support underwriting decisions with clear analytical outputs, including expected loss ratio, technical price, current price adequacy, proposed renewal action, and profitability outlook.
• Work with underwriting to ensure pricing recommendations are commercially practical but technically disciplined.

5. Claims, Provider and Cost-Control Analytics

• Analyze claims experience to identify key drivers of medical cost, including provider behavior, benefit utilization, chronic conditions, high-cost cases, outpatient trends, emergency room usage, pharmacy trends, diagnostics, maternity, dental, optical, and other major cost categories.
• Support claims, network, fraud/waste/abuse, and cost-control teams with actionable analytics.
• Identify unusual claims patterns, outlier providers, abnormal utilization, possible leakage, and areas requiring medical management intervention.
• Support the development of analytics for provider negotiation, network tiering, tariff review, discount evaluation, and provider performance management.
• Quantify the financial impact of cost-containment initiatives and monitor whether agreed actions are producing measurable improvement.

6. Dashboarding, Reporting and Management Information

• Build and maintain dashboards for portfolio performance, pricing adequacy, renewal performance, claims trends, provider performance, channel profitability, SME performance, and management KPIs.
• Translate complex actuarial and analytical findings into clear business messages for senior management and non-technical stakeholders.
• Ensure reports are timely, accurate, repeatable, and aligned with business decision cycles.
• Develop early-warning indicators for deteriorating segments, adverse claims trends, pricing inadequacy, high-risk clients, and unprofitable distribution channels.
• Support monthly, quarterly, and annual business performance reviews.

7. Product, Benefit and Profitability Initiatives

• Support product design and product enhancement through data-driven analysis of benefits, pricing, utilization, market competitiveness, and profitability.
• Recommend changes to product features, benefit limits, deductibles, co-payments, network design, underwriting rules, and pricing factors to improve profitability and sustainability.
• Support SME product pricing, package pricing, aggregator pricing, and segment-specific pricing strategies.
• Evaluate profitability initiatives and quantify expected and actual financial impact.
• Support business growth while maintaining underwriting discipline and technical pricing adequacy.

8. Cross-Functional Actuarial and Business Support

• Work closely with the Appointed Actuary and internal actuarial function to provide accurate data, analysis, assumptions, and explanations required for actuarial deliverables.
• Support actuarial reviews related to health portfolio performance, pricing adequacy, reserve-related analysis, claims development, and business planning.
• Collaborate with finance on expense allocation, combined ratio analysis, profitability reporting, and financial planning.
• Collaborate with distribution and sales teams to monitor channel performance, pricing behavior, discount discipline, and profitability by source of business.
• Contribute to the medium- to long-term health business strategy by providing reliable technical analysis and business insights.

9. Process Improvement and Tool Development

• Improve internal pricing, underwriting, reporting, and portfolio monitoring processes based on analysis outcomes.
• Support automation of recurring pricing and analytics tasks to reduce manual work and improve reliability.
• Work with actuarial, underwriting, IT, and data teams to develop and implement pricing tools, portfolio dashboards, renewal trackers, and profitability monitoring tools.
• Ensure pricing methodologies reflect current market practice, internal experience, regulatory requirements, and business strategy.
• Document pricing assumptions, methodologies, model logic, data sources, and governance controls.

10. Team Development

• Initially operate as a hands-on technical manager responsible for personally delivering key pricing and analytics outputs.
• Over time, support the recruitment, training, and development of junior analysts or pricing resources as the health analytics and pricing function expands.
• Build technical capability within the team in actuarial pricing, health claims analytics, SQL/Python/R, dashboarding, and business interpretation.
• Establish working standards for analysis quality, documentation, model control, and stakeholder communication.

Education:

• Bachelor’s degree in Actuarial Science, Statistics, Mathematics, Data Science, Finance, Economics, Engineering, or a related quantitative discipline.
• Actuarial qualification in progress is preferred, such as SOA, IFoA, or equivalent actuarial exams.
• Fully qualified actuary status is an advantage but not mandatory.
• Strong actuarial pricing experience may be accepted in place of formal actuarial qualification, especially if gained in health insurance

Experience:

• Minimum 6 years of relevant experience in health insurance pricing, actuarial analytics, portfolio analytics, underwriting analytics, or claims analytics.
• Experience in Corporate and/or SME health insurance pricing is strongly preferred.
• Prior experience in the Saudi or GCC health insurance market is highly desirable.
• Strong understanding of health insurance claims behavior, medical inflation, utilization trends, provider cost drivers, network impact, benefit design, and renewal pricing.
• Experience developing pricing models, dashboards, and management reports.

Personal Attributes / Skills:

• Strong stakeholder-management skills across underwriting, actuarial, claims, network, finance, IT, and sales.
• Comfortable working with incomplete data while clearly stating assumptions, limitations, and risks.
• Proactive in identifying issues, recommending actions, and following through on implementation.

Others:

• Advanced Microsoft Excel, including complex formulas, pivot tables, Power Query, VBA, and model-building capability.
• Strong SQL skills for data extraction, validation, reconciliation, and analysis.
• Working knowledge of Python or R for statistical analysis, pricing models, automation, and large-data handling.
• Experience with Power BI, Tableau, or similar dashboarding tools.
• Understanding of actuarial and statistical pricing methods, including GLM, regression, credibility, trend analysis, frequency/severity analysis, claims development, and scenario testing.