Senior Actuarial Analyst

TL;DR

Senior Actuarial Analyst (Healthcare): Maintain CMS HCC and RxHCC models for member risk scores and support revenue accruals, forecasting, and bidding with an accent on automation, data pipelines, and ROI tracking. Focus on building scalable analytic tools, analyzing complex healthcare claims data, and delivering insights for pricing, reserving, and value-based care strategy.

Remote in the USA

$96,000 - $125,000 USD

Company

We are reinventing health insurance by combining data, custom software, and analytics to empower clinical interventions and personalized care.

What you will do

• Maintain internal CMS HCC and RxHCC models for calculating member-level risk scores.
• Support monthly close processes with risk-adjusted revenue accruals and results analysis.
• Build reports to track ROI on risk adjustment initiatives.
• Develop risk scores for forecasting and bidding, providing support on pricing, reserving, trend analysis, and value-based care.
• Build automated actuarial tools and data pipelines.
• Communicate analysis and findings to leadership and cross-functional teams including Data Science, Finance, Operations, and Engineering.
• Support Sarbanes-Oxley compliance through process design, peer review, and control testing.

Requirements

• At least 1 year experience in health insurance; Medicare experience preferred.
• Completed at least two actuarial exams.
• 2+ years experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data.
• 2+ years programming experience (SQL, R, Python, SAS, VBA).
• Experience building analytic dashboards and automated tools for actuarial analysis.
• Self-starter with high internal drive and motivation.

Culture & Benefits

• Competitive base salary, equity, performance bonuses, 401k matching, and regular compensation reviews.
• Comprehensive medical, dental, vision coverage, mental health resources, and flexible time-off policy.
• Remote-first culture with No-Meeting Fridays, monthly company holidays, office setup reimbursement, cell phone/internet stipend.
• Professional development via learning programs, mentorship, funding, and performance feedback.
• Paid parental leave, Employee Stock Purchase Plan (ESPP), and eligibility for Actuarial Student Program.