This position is remote.

The Senior Actuarial Analyst is a key individual contributor responsible for advanced actuarial analysis, financial modeling, and data-driven insights across multiple areas, including reserves, risk adjustment, Part D, bid review, and pharmacy analytics. This role applies actuarial methodologies to evaluate pharmacy and healthcare trends, develop forecasts, and assess financial risk in a dynamic, regulated environment. The position partners cross-functionally with finance, pharmacy, clinical, operations, and external stakeholders to deliver accurate, transparent, and actionable insights.

General Duties/Responsibilities (May include but are not limited to):

• Develop, maintain, and audit actuarial models and traditional actuarial methods to support monthly reserve balances, RAF accruals, Part D pass-through accruals, forecasting, trend analysis, and financial projections.
• Analyze healthcare cost and utilization trends, including pharmacy, medical cost drivers, claim adjudication, and utilization management KPIs.
• Support pricing, reserving, and financial planning activities, including budget and forecast cycles; recommend changes to methodologies based on changing circumstances and operational deviations.
• Collaborate with the HealthPlan Economics and Medicare Risk Adjustment teams, as well as cross-functional partners, to review financial performance across markets and translate complex analytics into clear business insights.
• Conduct data-driven analyses to support strategic decision-making, evaluate program performance, and assess risks and opportunities.
• Communicate the purpose and function of actuarial methods and analyses clearly to stakeholders outside the department, including leadership audiences through reports, dashboards, and presentations.
• Ensure data integrity, validation, and reconciliation across multiple data sources to support regulatory and financial reporting requirements.
• Other duties as assigned.

Supervisory Requirements:

N/A

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.The requirements listed below are representative of the knowledge, skill, and/or ability required.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Experience:

3-5 years minimum of required work experience

Education/Licensure:

Requires a college degree with at least a minor in actuarial science, mathematics, statistics, economics, or equivalent business experience

Other:

Previous knowledge of Medicare Advantage is preferred

ASA designation or has completed the majority of the courses to complete the ASA designation

Programming experience in SQL, R or Python is a plus

Curious mindset and eagerness to learn within the actuarial field and also outside the traditional actuarial field

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $85,696.00 - $128,543.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.