New

Lead Analyst, Pricing

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
Feb 20, 2026
For assigned line(s) of business, the Lead Actuarial Analyst will: Lead the pricing and rating of HMSA's products, including the following: Collecting and analyzing historical experience data, developing projections and modeling financial outcomes under various rating scenarios. Regularly updating the rating methodology and factors for HMSA's ACA Individual and Small Group lines of business, including pricing model updates, Risk Adjustment payment analysis and associated rate filings documents preparation. Supporting the development of annual Medicare bid submissions and group retiree pricing, including pricing soundness check on gain/loss), risk score and payment, advising on process improvement etc. Support QUEST program including capitation rate impact analysis, regulatory compliance and data integrity & encounter analysis. Configuring and testing rate tables and factors in HMSA's systems. Lead complex trend analysis and projections, including: Monitoring emerging experience monthly, reconciling this against other sources and comparing against budget/forecast. Analyzing significant utilization, unit cost and other trend drivers, as well as variances against budget/forecast. Based on emerging trends, known/projected provider contract and other key drivers, lead the development of trend forecasts to be used for financial projection and rating purposes. Produce ad-hoc financial & statistical analyses, data pulls or studies, as needed. Assist the annual budget and reforecast of various LOBs. Other financial reporting duties, as assigned. Lead the creation of revenue and expense projections at the line of business level. Monitor emerging experience against these projections and produce variance analyses on a regular basis. Performs all other miscellaneous responsibilities and duties as assigned or directed.