Lead – Value Management Full Time

Business

Health Insurance

Unit

Aditya Birla Health Insurance Company Ltd

Location

Indiabulls, Mumbai

Poornata Position Number of the job

Reports to: Poornata Position Number

Poornata Position Title of the job

Lead – Value Management

Reports to: Poornata Position Title

Head Transformation

Function

Finance & Accounts

Reports to: Function

Value Management

Department

Value Management

Reports to: Department

Finance & Accounts

Designation of the Employee

Associate Vice President

Designation of the Manager

Head Transformation

Date of writing/updation of JD

December 2023

• Job Purpose: Write the purpose for which the job exists (in 2-3 lines)

The purpose of the role is required to ensure and lead Actuarial analytics with the vision that the products developed meet the needs of the company, customer and distributors. This will involve activities spanning gathering data, framing assumptions, building pricing models, performing calculations, comparisons with competition, performing sensitivity analysis, developing test cases and UAT of IT system developments .

• Dimensions: Mention quantitative or qualitative parameters that are relevant for the job and provide a better understanding of the scope and scale of the job.

Team Size (Function Workforce Number)

Particulars

FY 23

FY 24

FY25

Direct

2

2

2

Indirect

Marketing Budget

Metric

Units

FY20

FY21

FY22

Departmental Budget

Rs Mn

NPS

Metric

Units

FY20

FY21

FY22

NPS Score

Delta Improvement

of 5% over LY

Delta Improvement

of 5% over LY

Delta Improvement

of 5% over LY

• Job Context & Major Challenges: Write the specific aspects of the job that provide a challenge (internal and external) to the jobholder in the context of the Business/Unit/Function/Department/Section

About The Health Insurance Industry –

While the current market sees more than 15 non-life players in the private space and 5 exclusive private players in the health insurance space trying to capture a sizable market share, the nationalized service provider (6) remains a strong competitor. In addition to this the business dynamics are such that the overall market on an annual basis which is to the tune of roughly 10,000 Crs sees close to 85 % of the business renewing with the existing service provider itself. This narrows down the opportunity of the fresh business actually being seriously fought in the market to approximately 1500 odd Crs. With the SME and the start-ups being the driving force of Indian economy, the opportunity to cater to these segments is immense and is increasing manifold year on year. The challenge here therefore remains as to how we capture a larger share of the opportunity by developing specific solutions to cater each segment of the business. Also by creating an inexpensive and standardized solution to increase the reach into the pockets of channel partners across the country to harness on their captive business and explore new opportunities with them.

Market Opportunities – With the advent of medical advancements, lifestyle changes, change in Indian socio-economic scenario and Indian healthcare space, and the insurers are facing challenges to cater to the needs of this diverse clientele. Increasingly Indian customers have started considering health insurance partners as extensions of health advisers. In this scenario it becomes extremely important to understand their psyche and then provide tailored solutions with wellness benefits which would help them meet their end objectives and bring in profitable revenue source for the company.

About The Aditya Birla Health Insurance –

Aditya Birla Health Insurance Co. Limited (ABHICL) was incorporated in 2015 as a 51:49 joint venture between Aditya Birla Capital Limited (ABCL) and MMI Strategic Investments (Pty) Ltd. ABHICL commenced its operations in October 2016.

ABHICL has entered the competitive health insurance market with an aim to expand the category to wider customer segments, beyond the ones that health insurance companies traditionally have marketed to. As the 6 th entrant in a category with well-established players, ABHICL is creating differentiation and equity for itself though the unique business proposition of “Health Insurance for All”, a one of a kind proposition in India at the moment. This is a philosophy that is being built through every single consumer touch point and into every single backend process of the company to ensure a customer’s experience of our proposition is continuous and seamless.

ABHI’s unique offering to market includes proposition includes –

• A Comprehensive Incentivized Wellness Program that will attract the young and health conscious and will motivate, guide and reward them to stay healthy
• A Chronic Care Management Program to cater to the unmet needs of a growing Indian population of those suffering from chronic lifestyle conditions like Diabetes, Asthma, High Cholesterol and Hypertension from Day 1
• ABHICL serves as an enabler and influencer of health and healthcare choices that customers make, in addition to being a payer of healthcare expenses. Thus, ABHICL would act like a much needed catalyst to grow the prevalent health insurance landscape in India through product innovations and a wider choice of consumer relevant products.

Role Context

• Implement advance actuarial analytics projects, which involves having very good understanding of
• Data Management
• Programming Skills
• Statistical and Analytical Skills
• Knowledge of New technologies in Analytical field

Apart from the technical know-how and knowledge, the role is required to demonstrate good people and project management skills:

Key Challenges for the role –

• Being dynamic and having quick turnaround time for pricing
• Ensuring methodology and logic used remains relevant and appropriate
• Anticipating potential obstacles in completing the tasks, goals or projects and developing solutions
• Ensuring in-depth understanding of general business principles, practices and trends and their broad and significant strategic implications on the organization
• Solving unstructured issues using a strong process and approach
• Developing innovative and implementable solutions to complicated problems under tight dead-lines
• Key Result Areas: Write the key results expected from the job and the supporting actions for each of these key result areas (For a majority of jobs typically there could be 4- 7 key result areas)

Key Result Areas

Supporting Actions

Pricing for New Plans

• Modelling the utilization pattern of various benefits under the plan
• Discussion with various departments on likely costs and take up rates
• Giving feedback on areas where re negotiation can take place

Repricing for Existing Plans

• Repricing of existing plans to ensure profitability and growth
• Suggest mix of benefit for optimal pricing exercise and benefit combination

Framework for Assumptions vs Actual analysis

• Work with Finance to design the framework for A vs E analysis
• Suggest the required changes and enhancement to the process
• Introduce stochastic estimation of utilization and model the likely scenarios

Advance Actuarial Analytics (Retail)

• Pattern Detection in Retail Customers
• Identification of Anti-Selection pockets in various products
• Illness Specific / Age Specific analytics
• Develop and implement the analytical strategy for the actuarial department, aligning it with the overall business goals of the company. in Portfolio Ageing Analysis
• Drive the development and implementation of predictive models for various actuarial purposes, including pricing, reserving, and risk assessment.

Advance Actuarial Analytics (Group)

• Identification of Profitable segments
• Running of GLM in Group Member level data

Product Design and Pricing

• Support in preparation of feasibility report of innovative features in the product design
• Coordinate with Experience monitoring team for data required for pricing
• Identify risk and rating factors of the product
• Support in framing Pricing assumptions
• To build pricing models and derive technical pricing
• Developing market intelligence for products and pricing requirements
• Support in preparation of Technical justification for the product
• Support in Preparation of pricing documents for IRDAI
• Other tasks may be required from time to time as appropriate to the job and need of the organization.

Repricing for Existing Plans

• Repricing of existing plans to ensure profitability and growth
• Suggest mix of benefit for optimal pricing exercise and benefit combination

Team Development

• Need to stay updated on the industry trends and time to time change in the regulations and code of conduct values
• Self-grooming and learning is a journey and hence need to undergo training, webinars, as well as undergo professional courses to grow and excel.
• Encourage Team/nominate them to undergo necessary training programs to perform their work effectively as well as excel.

Pricing insurance products and evaluating claims

• The role is responsible to set prices for insurance products and evaluate claims.

Assessing The Financial Impact Of Potential Business Decisions

• Analysis of data and risk to assess the financial impact of potential business decisions.
• Evaluating features of an insurance product to attract more sales
• Job Purpose of Direct Reports: Describe the job purpose of the direct report/s to the job (in 2-3 lines for each report)

Senior Manager/Manager – Actuarial Analytics – The purpose of the role is to apply advanced analytics and actuarial methodologies to gain insights, make data-driven decisions, and support strategic initiatives

• Relationships: Describe the nature and purpose of most important contacts or relationship (except superior/team members) with individuals, departments, organizations inside and outside of the organization, that job is required to interact with in order to deliver the job objectives

Relationship Type Frequency Nature

Internal

Finance Team

Once a week

Exchange and validation of information

Pricing Team

Once a week

Share information related to performance of products

Validations of assumptions used in product design and pricing

Information required for pricing of new products

IT Team / MIS Team

Once a week

Data Related Issues and Automation requirements

Claims Team

Once a week

To understand and identify and trends or changes in claims processes / Fraud model / Data Collection

Underwriting ( Group and Retail )

Once a month

To identify any change in practices / Data collection

Peer reviewers

As per need

Send out information as required, ensure smooth reviews

Software providers

As per need

Send out information as required

• Organizational Relationships: Provide the structure for a level above and below the position for which this job description is written. Use position titles in the structured and indicate all the reports of the position.

SIGN-OFF: Provide the name of the Manager and the jobholder. Signature needed for the hard copy of the JD. Hard copy to be maintained in the organizational record.

Job Holder

Reports to – Manager

Name

Signature (needed for the hard copy)