Senior Actuary/Financial Analyst
RemoteMedicare AdvantageMedicaidCommercial Employer HealthStop LossExperience StudiesPredictive Modelling & MLBusiness Intelligence & Reporting
Role Summary
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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
