Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $121,846.40 Maximum Offer $190,798.40 Now Hiring: Manager-Business Insights Actuary Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Manager-Business Insights Actuary Type of Opportunity: Full time Job Exempt: Yes Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Weekday Schedule Monday-Friday (United States of America) Responsibilities: The Manager-Business Insights Actuary serves as the primary analytics partner to business leaders across Medicaid, ACA, Medicare Advantage, and ASO lines of business. This role is responsible for translating complex data into clear, actionable insights that drive financial performance, inform strategic decisions, and improve total cost of care. This role sits within Medical Economics and is accountable for ensuring stakeholders receive decision-ready reporting with a direct linkage to financial outcomes and organizational priorities. Some key responsibilities include: - *Serve as the primary Medical Economics partner to assigned lines of business, including Medicare Advantage, Medicaid, ACA, and ASO - Engage regularly with business leaders to understand priorities, pressures, and decision needs - *Translate business questions into structured analytical approaches and actionable outputs - * Ensure insights are clearly tied to financial impact, performance targets, and strategic objectives - *Develop and deliver high-impact, executive-ready reporting focused on performance, trends, and opportunities, providing clear “so what” and “now what” recommendations - Identify emerging risks and opportunities across cost, utilization, and revenue drivers - Create narratives that connect data to decisions, enabling leaders to take timely action - Partner with finance and actuarial teams to ensure alignment between reported insights and financial outcomes (e.g., GL, forecasts, MLR) - Support evaluation of performance improvement initiatives and business strategies - Ensure consistency and accuracy in how performance is measured and communicated - Partner with internal teams to enhance dashboards, reporting tools, and user experience - Standardize and streamline recurring reporting while elevating analytical depth - Ensure reporting evolves with business needs and supports decision-making at all levels - Work closely with Medical Economics leaders across Cost Strategy, Cost Optimization, and Data Infrastructure to ensure alignment - Partner with analytics, actuarial, finance, clinical, and network teams to deliver integrated insights - Act as a connector across teams to ensure insights are comprehensive, aligned, and actionable Qualifications: - Bachelor’s degree in a quantitative or business-related field (e.g., Economics, Finance, Actuarial Science, Statistics, Public Health) or equivalent experience - 5+ years of experience in healthcare strategy, medical economics, finance, or analytics - Experience supporting Medicare Advantage, Medicaid, ACA, or other health plan lines of business - Experience developing executive-level presentations and facilitating stakeholder discussions - Strong analytical skills with the ability to translate data into actionable insights - Experience developing executive-level reporting and presentations - Experience with tools such as SQL, Tableau, Excel modeling, or similar analytics platforms All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

• Provide support to audit teams regarding disclosures in company’s financial statements. • Review actuarial assumptions and methodologies according to applicable regulatory frameworks (e.g. OJK, IFRS). • Check reasonableness of reserves, data appropriateness and compliance with statutory requirements. • Give recommendations to clients regarding their actuarial assumptions and methodologies. • Help in providing meaningful feedback to the clients with regards to insurance risk management. • Engage in the preparation/implementation of IFRS 17, the new Accounting Standard for Insurance Companies.

• Apply actuarial principles to build models and perform analysis that supports Aledade's forecast process, risk management initiatives, and contracting efforts • Work with healthcare data from various sources to perform actuarial analysis and generate insights for business strategy development • Become a data expert for the financial structure and methodology of value-based contracting

• Evaluate and optimize portfolio performance through detailed loss ratio and combined ratio analysis • Conduct comprehensive portfolio risk assessments using statistical models and AI-driven techniques • Focus on catastrophe modeling and exposure management, enhancing traditional modeling using machine learning techniques • Leverage AI/ML techniques to automate actuarial workflows and improve predictive modeling