Actuarial Analyst III
Medicare AdvantageBusiness Intelligence & ReportingPredictive Modelling & MLPricing & Rating
Role Summary
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Senior health actuarial analyst focused on Medicare risk adjustment, pricing/financial analysis, and executive reporting. You will produce risk-adjustment estimates, develop risk score reporting, support forecasts/filings, and partner with operational teams across the organization. Role based in the United States, requiring strong data management and Power BI experience.
JOB DESCRIPTION SUMMARY
- Lead Medicare risk adjustment estimates and risk score reporting
- Perform pricing/financial analysis to support payer/provider negotiations
- Build reports and dashboards with Power BI and Cozeva
- Manage large healthcare datasets and communicate results to leadership
- Mentor and peer-review junior actuarial analysts
DOMAIN EXPERTISE
- Medicare risk adjustment
- risk score reporting and analysis
- financial modeling for payer and provider negotiations
- experience with managed care systems (Epic, Cerner, GE Centricity)
KEY REQUIREMENTS
- 5+ years working with data and actuarial models
- Expertise in Medicare risk adjustment estimates and reporting
- Experience with managed care applications (GE Centricity, Epic, Cerner)
- 5+ years in financial modeling for payer/provider negotiations
- Bachelor's degree in a quantitative discipline required
TECH STACK
- Power_BI
- Other_BI_Tool
