Role Description
We are looking for a detail-oriented Senior Actuarial Support Analyst to join our Actuarial team. In this role, you will be responsible for evaluating cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process. The ideal candidate will have extensive experience in healthcare analytics, financial modeling, and prior authorization, along with a strong strategic mindset and data-driven problem-solving skills. The work will be fast-paced and project-based, with evolving needs - requiring curiosity, flexibility, and grace under pressure.
This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.
What youβll do:
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Design and maintain complex financial models to track and analyze cost-saving initiatives, providing regular updates and insights to senior leadership and stakeholders.
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Perform advanced data analysis to assess prior authorization & claims trends, decision patterns, and cost drivers.
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Lead the design and development of financial models to quantify the impact of proposed cost-saving initiatives and forecast cost reduction outcomes for business cases.
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Use statistical and data visualization tools to identify trends, patterns, and anomalies in claims data that may indicate areas for improvement on savings.
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Prepare detailed and executive-level reports and presentations that summarize cost-saving achievements, project performance, and future cost-saving potential.
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Act as a trusted advisor to leadership and key internal & external stakeholders, providing strategic insights, recommendations, and guidance on cost-saving strategies.
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Work closely with clinical and customer success teams to understand authorization challenges, provide analytical insights, and offer actionable recommendations to resolve issues.
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Lead post-implementation assessments to measure the impact of cost-saving initiatives, ensuring continuous refinement and long-term sustainability of improvements.
Qualifications
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5 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting.
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Proficiency in data analytics and visualization tools, for example SQL, Tableau, Power BI, advanced Excel.
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Strong understanding of healthcare cost drivers and medical claims data.
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Demonstrated experience in data cleaning, data analysis and problem-solving skills.
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Ability to transform complex data into actionable insights and clear, concise reports.
Requirements
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Familiarity with prior authorization, utilization management processes.
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Proficient in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark).
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Experience with prior authorization & utilization management data.
Benefits
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Fully remote opportunity with about 5% travel.
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Medical, dental, vision, life, disability insurance, and Employee Assistance Program.
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401K retirement plan with company match; flexible spending and health savings account.
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Flex Time Off + company holidays.
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Up to 14 weeks of paid parental leave.
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Pet insurance.
Interview Process
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Connect with Talent Acquisition for a Preliminary Phone Screening.
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Meet your Hiring Manager!
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Team Interview.
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Cross-Functional.
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Executive Interview.