Lead Actuarial & Risk Modeling Specialist – Data Science & AI (US Healthcare)
RemoteMedicare AdvantageMedicaidCommercial Employer HealthPredictive Modelling & MLReserving & ValuationRegulatory Reporting
Role Summary
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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
