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Role Summary

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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

Loading...

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

Job Overview

Salary
Salary not specified
Years of Experience
5+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Senior health actuary with 5+ years in plans/ACOs/consulting, experienced in Medicare/Medicaid/commercial claims analytics, comfortable progressing toward or holding ASA/FSA and presenting complex methodology to external stakeholders.

Benefits

Equity/Stock OptionsHealth InsuranceRemote First
Fresh Role
Premium Window
1d
1 days ago

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Job Overview

Salary
Salary not specified
Years of Experience
5+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Senior health actuary with 5+ years in plans/ACOs/consulting, experienced in Medicare/Medicaid/commercial claims analytics, comfortable progressing toward or holding ASA/FSA and presenting complex methodology to external stakeholders.

Benefits

Equity/Stock OptionsHealth InsuranceRemote First
Fresh Role
Premium Window
1d
1 days ago

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Health/Insurtech/IC Level
Haystack Health

Senior Actuary/Financial Analyst

Haystack Health•United States•1d ago
RemoteMedicare AdvantageMedicaidCommercial Employer HealthStop LossExperience StudiesPredictive Modelling & MLBusiness Intelligence & Reporting

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