Key Duties and Responsibilities

Data Collection & Management

• Extract, clean, validate, and manage data from core insurance systems, provider systems, and other sources.
• Ensure data integrity, accuracy, and consistency across all reporting platforms.

Claims & Utilization Analysis

• Analyze claims data to identify trends in utilization, fraud, wastage, abuse, and cost drivers.
• Monitor high-cost claims, chronic cases, and provider performance.
• Support fraud detection and investigation initiatives.

Underwriting & Pricing Support

• Provide data analysis to support pricing, underwriting, and risk assessment.
• Develop experience analyses for products, client portfolios, and provider networks.
• Assist in setting benefit limits, deductibles, and co-pay structures using data insights.

Reporting & Dashboards

• Develop and maintain routine and ad-hoc management reports.
• Build interactive dashboards for management, underwriting, medical, finance, and sales teams.
• Automate reports to improve efficiency and timeliness.

Business & Strategic Insights

• Translate complex datasets into clear business insights and recommendations.
• Support strategic planning through predictive and trend analysis.
• Provide insights into customer behavior, disease burden, and cost containment opportunities.

Regulatory & Compliance Reporting

• Support regulatory reporting requirements (e.g., IRA, Ministry of Health, external auditors).
• Ensure accuracy and completeness of statutory and compliance-related data submissions.

Data Governance & Security

• Enforce data governance standards, confidentiality, and compliance with data protection laws.
• Support data audits and internal controls.

Cross-Functional Support

• Work closely with Claims, Underwriting, Finance, IT, and Business Development teams.
• Respond to data requests from internal and external stakeholders.

Qualifications and Experience

• Bachelor’s degree in Data Science, Statistics, Actuarial Science, Healthcare Analytics, or a related field
• Prior experience in data analysis within the health insurance industry is an added advantage

ANTI-MONEY LAUNDERING (AML) EXPECTATION

The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and its subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

Performs simple clerical duties by applying office procedures including answering calls, managing basic financial transactions and recording, typing or word processing, filing, and other ad-hoc activities to increase efficiency.

Responsibilities

Administration

• Conduct data entry into company systems, and file information using established procedures to ensure information is accurate and accessible.

Document Management

• File records or documents as instructed.

Document Preparation

• Input content into standard templates. Also take responsibility for collating materials and photocopying them.

Work Scheduling and Allocation

• Work according to an assigned schedule.

Operations Management

• Carry out operational tasks by following established processes. Involves working within given settings or parameters.

Internal Client Relationship Management

• Exchange information with internal clients by having courteous interactions with them.

Operational Compliance

• Follow a straightforward mandatory procedure to ensure that work is carried out to the required quality standards and/or to ensure adherence to external regulatory codes and internal codes of conduct.

Data Collection and Analysis

• Perform basic data entry tasks.

Personal Capability Building

• Develop and maintain excellent skills by participating in assessment and development planning activities as well as formal and informal training and coaching.