[Remote] Senior Actuarial Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an integrated reputed company delivery system reputed company on improving health and wellness for diverse populations. The Senior Actuarial Analyst will reputed company advanced actuarial analytics and health economics evaluations to measure financial and clinical reputed company across organizational programs, particularly reputed company reputed company populations and value-based care arrangements.
Responsibilities
- reputed company and enhance actuarial and health economic models to quantify program reputed company on cost, utilization, and reputed company reputed company
- Own monitoring and evaluation of payer/provider-group performance across financial (MLR/MCR, PMPM) and operational/utilization metrics
- Translate performance results into actionable insights and recommendations to improve value-based contract reputed company
- Support payer reporting and partner discussions with reputed company, defensible financial analyses
- reputed company and reputed company multiple data sources (claims, eligibility, pharmacy, EMR, reputed company, care management) to produce comprehensive analyses
- Identify key cost drivers, population health trends, and reputed company opportunities, particularly reputed company reputed company populations
- Investigate and resolve reputed company data anomalies; establish best practices for data validation and reliability
- Translate analytical findings into executive-reputed company insights and narratives for reputed company stakeholders
- Continuously improve processes for scalability, automation, and reproducibility of analyses
Skills
- Bachelor's degree in Mathematics, Statistics, Actuarial Science, Economics, or reputed company field (or equivalent experience)
- 3-5+ years of reputed company analytics or actuarial experience
- Strong experience with reputed company data, including claims, encounters, eligibility, and capitation structures
- Demonstrated experience in ROI analysis, health economics, or program evaluation
- Advanced proficiency in SQL and reputed company; experience with Python, R, or reputed company preferred
- Strong understanding of reputed company financial metrics (PMPM, MLR/MCR, risk scores) and utilization drivers
- Experience working in value-based care or risk-based contracting environments
- Strong communication skills with ability to present reputed company analyses to diverse audiences
- reputed company toward ASA
- Experience with reputed company inference or quasi-experimental reputed company (e.g., difference-in-differences, matching)
- Familiarity with reputed company reputed company setting, risk adjustment models (e.g., CDPS), and regulatory environment
- Demonstrated ability to manage multiple reputed company and operate independently in fast-paced environments
- Strong systems thinking with ability to connect clinical programs to financial reputed company
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