Key Purpose

• Discovery Health administers a number of closed in-house employer medical schemes, as well as the largest open scheme in South Africa, the Discovery Health Medical Scheme. The Risk Intelligence team is responsible for the measurement and reporting of clinical experience for each of our client schemes, providing actuarial analytic support for managed care interventions, healthcare quality public reporting initiatives, provider contracting, and clinical profile reports of clinician utilisation patterns and adherence to evidence based clinical process measures.
• You will be responsible for technical healthcare actuarial analysis, which may include regular monitoring reports, as well as detailed investigations for various initiatives. You will be expected to deliver clear and reliable results on tight and high-pressured deadlines at times. The job entails applying the principles of risk adjustment, in the healthcare context, to the clinical analysis of claims data to deepen understanding of the scheme experience for guiding appropriate interventions to ensure sustainability through improvement of efficiency and quality of care. You may also be involved in assisting with the pricing of exciting new Discovery Health products before their launch. Data and model findings need to be clearly communicated to business users.

Competencies required:

• Excellent conceptual and technical ability
• Excellent communications, both written and verbal
• Comfortable presenting to stakeholders and team
• Healthcare experience and an understanding of clinical risk adjustment methodologies
• Manage complexity
• Excellent conceptual and technical ability
• Accuracy
• Analytical
• Verbal and written Communication

Personal Attributes and Skills

• Aligned to Discovery values and core purpose.
• An interest in the South African healthcare and medical scheme environment.
• Exceptional analytical and problem-solving skills.
• High-level of attention to detail.
• Results orientated and commercial thinking.
• Excellent communication and presentation skills
• A focus on delivering results and meeting client expectations.
• Ability to work collaboratively in a team environment and balance multiple priorities.
• Ability to work alone when required and to take initiative without supervision.
• Comfortable with change and a fast-paced work environment.
• Unwaveringly ethical and able to maintain confidentiality.

Qualifications & Experience:

• Actuarial science or Mathematical Statistics undergraduate degree
• Completion of CT series of actuarial board examinations
• Data and analytic work experience (1-3 years) (Beneficial)
• Understanding of risk adjustment methodologies (Beneficial)