Closer to a data-science crossover than a traditional modelling IC because claims querying and statistical programming are as central as actuarial analysis.
Senior Health actuarial analytics role on PeaceHealth’s Value Based Care team, remote within Oregon, Washington, or Alaska. You’ll build predictive and financial models from medical, pharmacy, clinical, and enrollment claims data across Medicare Advantage, Medicaid, and commercial business, using SQL and Python to support population health and value-based arrangements.
Requirements
Must have
Bachelor's degree in Math, Finance, Statistics, Actuarial Science or related field
Two or more SOA exams passed toward ASA or FSA designation
Minimum of 5 years of experience with advanced SQL and Python skills including claims data
Experience with risk score calculations
Proficiency in value-based care analytics: Medicare/Medicaid, Medicare Advantage, ACO models
Strong understanding of risk adjustment, HCC scoring and revenue forecasting methodologies
Experience in finance or healthcare industry settings
Proficient in MS Office applications (Word, Excel, Outlook, PowerPoint)
Strong analytical, organizational, and people skills
Ability to work independently with limited supervision
Proven ability to present technical concepts to non-technical audiences
Nice to have
Experience building actuarial models in SQL or Python
Experience with data visualization platforms like Tableau, Power BI, or Fabric
EPIC Certification EPIC Cogito
Understanding of HIPAA rules and regulations
Skills & Domain
ToolsExcelPower_BITableau
DomainValue-based care analytics for Medicare/Medicaid/Medicare AdvantageRisk score calculations and HCC codingExperience with CMS CMMI, ACO REACH, MSSP, Advanced Payment ModelsVBC modeling and population health analytics
