Full-Time Actuary

Actuarial and Financial Modeling: Develop and maintain actuarial and financial models for business needs and strategic goals. Design and develop financial models to quantify cost-saving initiatives' impact and forecast outcomes. Enhance actuarial models, ensuring accurate data and result validation using in-house or actuarial software.

Advanced Data Analysis: Conduct advanced data analysis for claims trends, approval/denial patterns, and cost drivers. Minimize waste and control costs through detailed financial data analysis. Identify trends, patterns, and anomalies using statistical and data visualization tools to provide actionable insights.

Risk and Opportunity Assessment: Assess and analyze financial risks and opportunities via actuarial methods and analyses. Stay current with actuarial research, industry standards, assumptions, competition, and legal/regulatory environment to inform decision-making.

Post-Implementation Assessments: Support post-implementation assessments to evaluate cost-saving initiative effectiveness and impact. Ensure continuous improvement and sustainability of implemented cost-saving strategies.

Collaboration and Influence: Collaborate with stakeholders (leadership, clinical teams, customer success teams) to understand business needs and challenges. Translate complex actuarial concepts into clear, non-technical recommendations for business partners and stakeholders. Provide expert guidance and strategic insights to influence decision-making and align with business goals.

Cost-Saving Initiatives: Support cost-saving projects by providing analysis and recommendations based on actuarial models and financial forecasting. Develop and present executive-level reports and presentations summarizing cost-saving achievements and project performance. Identify and implement innovative approaches (new technologies, data analysis tools, process improvements) to optimize cost savings.

Reporting and Strategic Recommendations: Prepare and present detailed reports and strategic recommendations to leadership and stakeholders on financial outcomes and performance metrics.

Requirements & Qualifications: 2+ years experience in healthcare analytics, cost containment, or similar roles in the healthcare industry (preferably payer, provider, or managed care). Bachelor's degree and ASA (Associate of the Society of Actuaries) are required. Familiarity with prior authorization and utilization management processes is desirable. Strong understanding of healthcare cost drivers, claims data, and prior authorization processes. Strong data interpretation, statistical analysis and problem-solving skills. Ability to transform complex data into actionable insights and clear reports. Proficiency in data analytics and visualization tools (SQL, Tableau, Power BI, advanced Excel).

Additional Skills: Strong interest and understanding of prior authorization data, claims and SDOH data. Proficient in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark). Excellent interpersonal skills. Passion for improving U.S. healthcare and helping each patient receive the best care possible. Self-starter, able to work independently in a fast-paced environment.

What is the last date for applying to the job?

Which countries are accepted for this remote job?