Actuarial Analyst - Health Plan
Core
Prepare and analyze data for Medicare Part D bids, maintain actuarial models, and perform financial projections for pharmacy costs.
Role type
Actuarial Analyst (Health Plan)
Builds
Medicare Advantage bid pricings, pharmacy cost reports, and contract models
Domain
US Healthcare / Medicare Advantage / Pharmacy Benefit Management
Deliverable
production ML models | dashboards & analysis
Required skills
Actuarial modeling, SQL (advanced), Microsoft Excel (V-Lookups, pivot tables), Data Warehouse querying, Financial forecasting, Medicare/Part D regulations knowledge
Preferred skills
Healthcare/Managed care experience, Network contracting knowledge, AI/automation curiosity
Technologies
SQL, Microsoft Office Suite (Excel, Access, PowerPoint), Data Warehouse
Responsibilities
Prepare and analyze data for Part D bids, develop comparisons between actual versus forecast, support ad-hoc analytics for provider contracting and product development, analyze historical data trends to establish assumptions, assist in Medicare Advantage bid pricing by testing benefit scenarios, monitor pharmacy cost budgets and forecasts, identify opportunities to streamline workflows and improve automation
Seniority
Junior to Mid-level, individual contributor