Manager-Business Insights Actuary

Location Address:

Compensation Pay Range:

Summary:

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.