Lead Actuarial & Risk Modeling Specialist – Data Science & AI (US Healthcare) at Fractal | Acturhire

Role Summary

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HIGHLIGHTS

Senior health actuarial lead role focused on US healthcare risk modeling. You will design and validate models for cost forecasting, risk adjustment, member stratification, and payment integrity, and translate actuarial models into scalable AI solutions. Remote contract role supporting enterprise AI initiatives with cross-functional stakeholder exposure.

JOB DESCRIPTION SUMMARY

Lead actuarial modeling for US healthcare (Medicare, Medicaid, Commercial)
Develop risk adjustment, morbidity, and cost-of-care predictive models
Translate actuarial models into scalable AI/Databricks solutions
Remote contract role; not eligible for visa sponsorship
Requires 10+ years of US healthcare actuarial or risk modeling experience

DOMAIN EXPERTISE

Medicare (MA, FFS, Risk Adjustment)
Medicaid / State program modeling
Commercial / Employer plan cost modeling
Cost modelling, utilization forecasting and trend analysis
Experience with claims, eligibility, provider datasets

KEY REQUIREMENTS

10+ years developing actuarial or financial models in US healthcare
Experience with Medicare, Medicaid, or Commercial/Employer plans
Advanced modeling: GLMs, survival analysis, time series
Hands-on experience with Python, R, and SQL (Databricks preferred)
Eligible to work in the US without sponsorship

TECH STACK

Databricks