Senior Actuary, Health Plan Analytics

Leading health plan and risk adjustment analytics, the full-time Senior Actuary, Health Plan Analytics will build member-level actuarial models, develop analytics for rate-setting, and translate complex data into customer-facing dashboards in a remote environment. Key responsibilities Build and maintain member-level actuarial models for risk adjustment performance and population health metrics across various health plan populations Develop analytics to support rate-setting for Medicare Advantage Bids, ACA rate filings, and value-based contracts Communicate model methodology and results effectively to both actuarial and non-actuarial stakeholders, including health plan executives Required qualifications Seven or more years of actuarial or actuarial-adjacent analytics experience in health plan pricing, risk adjustment, or medical economics Direct pricing or performance modeling experience across Medicare Advantage, MAPD, ACA, Medicaid, or value-based contracts Working knowledge of the CMS-HCC and ACA risk model, including RAF score calculation Demonstrated experience building member-level data models for reporting or dashboard tools like Tableau or Power BI Proficiency in SQL and at least one statistical or scripting language, such as SAS, R, or Python