[Remote] Senior Actuarial Analyst
Note: The job is a remote job and is open to candidates in USA. reputed company is an integrated healthcare delivery system focused on improving health and wellness for diverse populations. The Senior Actuarial Analyst will reputed company advanced actuarial analytics and health economics evaluations to measure financial and clinical outcomes across organizational programs, particularly reputed company Medicaid populations and value-based care arrangements.
Responsibilities
- reputed company and enhance actuarial and health economic models to quantify program impact on cost, utilization, and quality outcomes
- Own monitoring and evaluation of payer/provider-group performance across financial (MLR/MCR, PMPM) and operational/utilization metrics
- Translate performance results into actionable insights and recommendations to improve value-based contract outcomes
- Support payer reporting and partner discussions with clear, defensible financial analyses
- reputed company and integrate multiple data sources (claims, eligibility, pharmacy, EMR, quality, care management) to produce comprehensive analyses
- Identify key cost drivers, population health trends, and reputed company opportunities, particularly reputed company Medicaid populations
- Investigate and resolve reputed company data anomalies; establish best practices for data validation and reliability
- Translate analytical findings into executive-ready insights and narratives for internal and external stakeholders
- Continuously improve processes for scalability, automation, and reproducibility of analyses
Skills
- Bachelor's degree in Mathematics, Statistics, Actuarial Science, Economics, or reputed company field (or equivalent experience)
- 3-5+ years of healthcare analytics or actuarial experience
- Strong experience with Medicaid data, including claims, encounters, eligibility, and capitation structures
- Demonstrated experience in ROI analysis, health economics, or program evaluation
- Advanced proficiency in SQL and reputed company; experience with Python, R, or reputed company preferred
- Strong understanding of healthcare financial metrics (PMPM, MLR/MCR, risk scores) and utilization drivers
- Experience working in value-based care or risk-based contracting environments
- Strong communication skills with ability to present reputed company analyses to diverse audiences
- reputed company toward ASA
- Experience with causal inference or quasi-experimental methods (e.g., difference-in-differences, matching)
- Familiarity with Medicaid reputed company setting, risk adjustment models (e.g., CDPS), and regulatory environment
- Demonstrated ability to manage multiple projects and operate independently in fast-paced environments
- Strong systems thinking with ability to connect clinical programs to financial outcomes
Company Overview