Health Pricing Specialist

The Health Pricing Specialist is responsible for evaluating medical risk, developing accurate pricing recommendations, and ensuring the sustainability and competitiveness of health insurance portfolios.

Key Responsibilities

• Assess medical risk for both group and individual policies based on claims experience, demographics, and benefit design.
• Review clinical information, claims trends, and high-cost claim drivers.
• Translate underwriting assessments into clear, commercially focused recommendations.

Pricing & Financial Analysis

• Develop and validate pricing recommendations.
• Conduct claims trend analysis, including frequency, severity, and large-loss volatility.
• Build and refine pricing assumptions (e.g. inflation, credibility, pooling, and utilisation forecasts).
• Model the impact of benefit changes and perform scenario analysis.