Senior Actuarial Analyst

We are seeking a Senior Actuarial Analyst to support Medicaid and Value-Based Care (VBC) initiatives through advanced actuarial analysis, financial modeling, and healthcare analytics. This individual will play a key role in evaluating population health performance, monitoring financial outcomes, and driving data-informed decision making across value-based programs. The ideal candidate will bring a strong analytical background, hands‑on SQL experience, and deep knowledge of healthcare financial metrics including PMPM and MLR. Key Responsibilities Analyze Medicaid populations and value-based care arrangements to identify cost, utilization, and quality trends. Develop and maintain financial models supporting VBC programs, capitation arrangements, shared savings initiatives, and risk-based contracts. Perform PMPM (Per Member Per Month) analyses to evaluate healthcare cost drivers and support forecasting activities. Monitor and analyze Medical Loss Ratio (MLR) performance, providing actionable insights to leadership and operational teams. Utilize SQL to extract, manipulate, and analyze large healthcare datasets from multiple sources. Support actuarial forecasting, budgeting, and financial planning processes. Develop reporting and dashboards that track financial, operational, and population health performance metrics. Collaborate with Clinical, Network, Finance, Population Health, and Analytics teams to evaluate program effectiveness and identify opportunities for improvement. Conduct ad hoc analyses related to cost containment, utilization management, risk adjustment, and provider performance. Present findings and recommendations to stakeholders in a clear and concise manner. Qualifications Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field. 3+ years of actuarial or healthcare analytics experience, preferably within Medicaid, managed care, or value-based care environments. Progress toward ASA designation preferred. Advanced SQL skills with experience working with large healthcare claims and membership datasets. Experience performing PMPM cost analysis, trend studies, forecasting, and financial performance reporting. Strong understanding of MLR, healthcare economics, and actuarial principles. Experience supporting Value-Based Care programs such as MSSP, ACOs, shared savings arrangements, capitation, or other risk-based contracts preferred. Proficiency with Excel and data visualization tools such as Power BI, Tableau, or similar platforms. Excellent analytical, problem-solving, and communication skills. Preferred Experience Medicaid managed care experience. Knowledge of provider contracting, population health, and quality performance metrics. Experience working with healthcare claims, encounter, pharmacy, and membership data. Exposure to risk adjustment, forecasting, and financial modeling in a VBC environment. This role offers the opportunity to directly influence Medicaid and Value-Based Care strategy through sophisticated actuarial analysis, financial modeling, and data-driven insights. #J-18808-Ljbffr