Role Summary

HIGHLIGHTS

Senior health actuarial analyst role on the Network and Trend Analytics team in Oakland, CA. Lead financial analyses and modeling for provider contracting, forecasting, and provider reimbursement evaluation. Requires deep experience with healthcare claims, trend analysis, and SQL/SAS.

JOB DESCRIPTION SUMMARY

Lead financial modeling and forecasting for provider contracting (hospitals, physician groups, ASCs)
Analyze claims trends, assess population risk scores, and reprice historical data
Use SQL and SAS to run queries and manipulate large healthcare datasets
Prepare unit cost trend reporting and rate calculations using Excel
Hybrid role with business-unit-approved office visits (default hybrid model)

DOMAIN EXPERTISE

healthcare claims data analysis in managed care
provider contract financial analysis and reimbursement methodologies
trend forecasting and unit cost trend reporting

KEY REQUIREMENTS

Bachelor’s degree (minor in math, stats, CS or equivalent experience) required
6+ years of professional actuarial experience
5+ years analyzing healthcare claims data in a managed care setting
Proficiency with Excel and working with large datasets
Current working knowledge of SQL and/or SAS

TECH STACK

Excel

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead financial modeling and forecasting for provider contracting (hospitals, physician groups, ASCs)
Analyze claims trends, assess population risk scores, and reprice historical data
Use SQL and SAS to run queries and manipulate large healthcare datasets
Prepare unit cost trend reporting and rate calculations using Excel
Hybrid role with business-unit-approved office visits (default hybrid model)