Actuarial Analyst

We are looking for a detail-oriented Senior Actuarial Support Analyst to join our Actuarial team. In this role, you will be responsible for evaluating cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process. The ideal candidate will have extensive experience in healthcare analytics, financial modeling, and prior authorization, along with a strong strategic mindset and data-driven problem-solving skills. The work will be fast-paced and project-based, with evolving needs - requiring curiosity, flexibility, and grace under pressure. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Actuarial team and develop & maintain cost savings models. This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events. What you'll do: Design and maintain complex financial models to track and analyze cost-saving initiatives, providing regular updates and insights to senior leadership and stakeholders. Perform advanced data analysis to assess prior authorization & claims trends, decision patterns, and cost drivers. Lead the design and development of financial models to quantify the impact of proposed cost-saving initiatives and forecast cost reduction outcomes for business cases. Use statistical and data visualization tools to identify trends, patterns, and anomalies in claims data that may indicate areas for improvement on savings. Prepare detailed and executive-level reports and presentations that summarize cost-saving achievements, project performance, and future cost-saving potential. Act as a trusted advisor to leadership and key internal & external stakeholders, providing strategic insights, recommendations, and guidance on cost-saving strategies. Work closely with clinical and customer success teams to understand authorization challenges, provide analytical insights, and offer actionable recommendations to resolve issues. Lead post-implementation assessments to measure the impact of cost-saving initiatives, ensuring continuous refinement and long‑term sustainability of improvements. What you'll need: 5 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting, Proficiency in data analytics and visualization tools, for example SQL, Tableau, Power BI, advanced Excel, Strong understanding of healthcare cost drivers and medical claims data, Demonstrated experience in data cleaning, data analysis and problem-solving skills, Ability to transform complex data into actionable insights and clear, concise reports. Bonus: Familiarity with prior authorization, utilization management processes Proficient in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark) Experience with prior authorization & utilization management data. Benefits Fully remote opportunity with about 5% travel Medical, dental, vision, life, disability insurance, and Employee Assistance Program 401K retirement plan with company match; flexible spending and health savings account Up to 14 weeks of paid parental leave The salary range for this position is $105,000 to $115,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment. Interview Process* Connect with Talent Acquisition for a Preliminary Phone Screening Meet your Hiring Manager! Team Interview Cross-Functional Executive Interview *Subject to change About Cohere Health Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum- including policy, prior authorization, payment accuracy, and more- the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction. With the acquisition of ZignaAI, we've further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Cohere Health's innovations continue to receive industry wide recognition. We've been named to the 2025 Inc. 5000 list and in the Gartner Hype Cycle for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners. The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone. We can't wait to learn more about you and meet you at Cohere Health! Equal Opportunity Statement Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal. #J-18808-Ljbffr