Senior Actuarial Analyst
Core
Partner with the Actuarial team to support revenue, pricing, and long-term growth strategy by maintaining risk models, supporting monthly close, and building automated tools for healthcare data analysis.
Role type
Senior Actuarial Analyst (Health Insurance)
Builds
Automated actuarial tools, data pipelines, and reports for risk adjustment and revenue accruals.
Domain
Health Insurance / Risk Adjustment / Medicare
Deliverable
production ML models | dashboards & analysis
Required skills
SQL, Python, R, Health Insurance domain knowledge, Actuarial modeling (HCC/RxHCC), Data validation, Automated tool building, Sarbanes Oxley compliance
Preferred skills
Medicare Risk Adjustment experience, CMS EDS submissions, Analytic dashboard building
Technologies
SQL, Python, R
Responsibilities
Maintain internal CMS HCC and RxHCC models for calculating member level risk scores; Support the monthly close process including actuarial risk adjusted revenue accruals; Build reports to track ROI on risk adjustment initiatives; Support actuarial teams in developing risk scores for forecast and bidding; Provide actuarial support on risk adjustment, pricing, forecasting, reserving, trend analysis, and value-based care; Build automated actuarial tools and data pipelines; Support compliance under Sarbanes Oxley through process and tool design.
Seniority
Senior, hands-on IC