Role Summary

HIGHLIGHTS

Health-focused medical economics role supporting Medicare Advantage analytics in Nashville, TN. You will analyze claims, membership, and utilization to forecast revenue using HCC/RAF methodology and provide actuarial support to Operations, Clinical, and Finance teams. The role requires strong Excel and PowerBI skills and 4+ years' experience with health plans, ACOs, RBEs, or consulting.

JOB DESCRIPTION SUMMARY

Analyze healthcare cost drivers and utilization patterns for Medicare Advantage
Provide actuarial support and revenue forecasting using HCCs and RAFs
Work with Engineering to source data and build end-user reports
Use Excel and Power BI for analysis and presentation; SQL experience preferred
Associate-level role requiring 4+ years in health plan/ACO/RBE/consulting analytics

DOMAIN EXPERTISE

Experience with health plans, ACOs, RBEs, or consulting focused on health economics
Medicare Advantage actuarial support and profitability analysis
Experience with HCCs and RAFs for revenue forecasting
Claims, membership, and prior authorization data analysis
Product trend analysis using statistically valid methodologies