Senior Actuary, Health Plan Analytics

📋 Description

• The Senior Actuary, Health Plan Analytics will be responsible for developing actuarial models
• Build and maintain member-level actuarial models focused on risk adjustment performance, HCC
• Develop analytics supporting pricing strategies, Medicare Advantage bids, ACA rate filings
• Reconcile risk adjustment calculations using key healthcare data sources and extend analytical
• Partner with data engineering and product teams to design actuarial methodologies and translate
• Create forecasting and accrual models supporting financial planning, settlement estimates, transfer

🎯 Requirements

• 7+ years of actuarial or actuarial-adjacent analytics experience in health plan pricing, risk
• Proven experience modeling performance across multiple healthcare markets, including at least three
• Strong understanding of CMS-HCC and ACA risk models, RAF calculations, ICD-10 diagnosis coding, and
• Experience building member-level data models that support reporting, analytics platforms, or
• Proficiency in SQL and experience with statistical or scripting languages such as SAS, R, or Python.
• Familiarity with healthcare data sources including MMR, MOR, MAO-004, Beneficiary-Level files

🎁 Benefits

• Competitive salary range of $150,000 – $185,000, depending on experience, skills, and location.
• Medical, dental, and vision insurance coverage.
• 401(k) retirement plan with employer matching contributions.
• Generous paid time off (PTO) program.
• Fully remote work opportunity.
• Opportunity to work on impactful healthcare analytics initiatives using modern technology and