Role Summary

HIGHLIGHTS

Senior health actuarial role focused on measuring cost savings from clinical trial enrollment for payers and ACOs. You will build and defend actuarial cost-savings models, analyse medical and pharmacy claims, and present methodology to credentialed actuaries and CFOs. Remote role based in the United States with preference for Central or Eastern time zones.

JOB DESCRIPTION SUMMARY

Build and maintain actuarial cost-savings and financial impact models
Analyse medical and pharmacy claims data to quantify avoided standard-of-care costs
Present and defend savings methodology to actuaries, CFOs, and health plan clients
Work across commercial and government lines: Medicare Advantage, Medicaid, commercial
Fully remote role with preference for Central or Eastern time availability

DOMAIN EXPERTISE

Healthcare actuarial or medical economics experience (5+ years)
Hands-on medical and pharmacy claims data analysis
Stop-loss and reinsurance accounting experience
Familiarity with Part D benefit design and rebate flows
Experience with Medicare Advantage, Medicaid MCO, and commercial lines

KEY REQUIREMENTS

5+ years in healthcare actuarial, medical economics, finance, ACO, PBM, or consulting
Deep hands-on experience with medical and pharmacy claims data
Familiarity with stop-loss/reinsurance accounting and Part D benefit design
Strong SQL and Excel skills; Python or R experience a plus
Proven ability to communicate methodology to credentialed actuaries and CFOs

TECH STACK

Excel
PowerPoint

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Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Build and maintain actuarial cost-savings and financial impact models
Analyse medical and pharmacy claims data to quantify avoided standard-of-care costs
Present and defend savings methodology to actuaries, CFOs, and health plan clients
Work across commercial and government lines: Medicare Advantage, Medicaid, commercial
Fully remote role with preference for Central or Eastern time availability

DOMAIN EXPERTISE

Healthcare actuarial or medical economics experience (5+ years)
Hands-on medical and pharmacy claims data analysis
Stop-loss and reinsurance accounting experience
Familiarity with Part D benefit design and rebate flows
Experience with Medicare Advantage, Medicaid MCO, and commercial lines

KEY REQUIREMENTS

5+ years in healthcare actuarial, medical economics, finance, ACO, PBM, or consulting
Deep hands-on experience with medical and pharmacy claims data
Familiarity with stop-loss/reinsurance accounting and Part D benefit design
Strong SQL and Excel skills; Python or R experience a plus
Proven ability to communicate methodology to credentialed actuaries and CFOs

TECH STACK

Excel
PowerPoint

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Build and maintain actuarial cost-savings and financial impact models
Analyse medical and pharmacy claims data to quantify avoided standard-of-care costs
Present and defend savings methodology to actuaries, CFOs, and health plan clients
Work across commercial and government lines: Medicare Advantage, Medicaid, commercial
Fully remote role with preference for Central or Eastern time availability

DOMAIN EXPERTISE

Healthcare actuarial or medical economics experience (5+ years)
Hands-on medical and pharmacy claims data analysis
Stop-loss and reinsurance accounting experience
Familiarity with Part D benefit design and rebate flows
Experience with Medicare Advantage, Medicaid MCO, and commercial lines

KEY REQUIREMENTS

5+ years in healthcare actuarial, medical economics, finance, ACO, PBM, or consulting
Deep hands-on experience with medical and pharmacy claims data
Familiarity with stop-loss/reinsurance accounting and Part D benefit design
Strong SQL and Excel skills; Python or R experience a plus
Proven ability to communicate methodology to credentialed actuaries and CFOs