Role Description
The Actuarial Analyst II is an experienced individual contributor who performs actuarial analyses supporting Medicare Advantage pricing, forecasting, reserving, risk adjustment, bid development, and financial performance management. The role independently manages defined analyses and workstreams, develops reliable models and reporting, and translates quantitative findings into clear recommendations for actuarial leadership and cross-functional partners. This position works closely with Finance, Product, Network, Operations, and clinical or risk-adjustment teams to identify financial risks, opportunities, and emerging trends.
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Develop and maintain actuarial analyses, models, and reporting that support pricing, forecasting, reserving, risk adjustment, and financial planning decisions.
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Analyze claims, utilization, membership, risk scores, provider performance, and benefit experience to identify financial trends, risks, opportunities, and key drivers.
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Prepare defined components of Medicare Advantage bid submissions, actuarial exhibits, and supporting documentation in accordance with established methodologies and regulatory guidance.
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Perform monthly and quarterly reserve, accrual, and financial-performance analyses; validate results, reconcile data, and explain material variances.
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Evaluate the financial impact of product, benefit, network, operational, and regulatory changes, and communicate implications to business partners.
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Build and improve repeatable actuarial models, tools, dashboards, controls, and documentation using sound data-management, validation, and version-control practices.
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Present analysis, assumptions, results, and recommendations to actuarial leadership and cross-functional stakeholders in a clear, concise, and audience-appropriate manner.
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Provide technical guidance and quality-review support to less experienced analysts, as assigned, while continuing to develop subject-matter expertise.
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Participate fully in the Actuarial Development Program by pursuing actuarial examinations, completing development activities, incorporating feedback, and applying new knowledge to work assignments.
Qualifications
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2-4 years of actuarial, healthcare analytics, insurance, financial modeling, or other relevant quantitative analysis experience.
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Experience working with large datasets, financial or actuarial models, and reporting tools.
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Demonstrated ability to independently organize and complete defined analyses, validate outputs, identify issues, and communicate findings.
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Experience partnering with nontechnical stakeholders to explain quantitative results and support decisions.
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Bachelorβs degree in Actuarial Science, Mathematics, Statistics, Finance, Economics, or related quantitative field; or equivalent combination of education and experience.
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Must actively participate in the Actuarial Development Program.
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Successfully passed 2-4 actuarial examinations.
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Actuarial modeling, forecasting, and financial analysis.
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Healthcare cost, utilization, membership, and risk-adjustment analytics.
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Cross-functional collaboration and stakeholder management.
Requirements
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Previous knowledge of Medicare Advantage.
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Programming experience in SQL, R or Python.
Benefits
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Pay Range: $77,905.00 - $116,858.00.
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Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.