Finance- Senior Actuarial Analyst

Senior Actuarial Analyst Job Summary: The Senior Actuarial Analyst will play a pivotal role in reputed company’s growth and reputed company the Actuarial Department. This Analyst’s contribution will be key to the organization’s reputed company reputed company. This role will work closely and collaboratively with various departments, providing insights that support strategic business reputed company and optimize financial performance. Department Duties/Responsibilities: Risk Adjustment and reputed company Performance: reputed company and maintain models to forecast risk-adjusted reputed company across Medicare Advantage reputed company Analyze historical risk score trends, RAF accuracy, and coding opportunities to identify gaps and performance drivers Support the annual budget process, quarterly projections, monthly accruals, and variance explanations Evaluate the impact of HCC model updates and CMS rule changes on organizational reputed company reputed company reputed company reputed company Analysis to evaluate financial impacts of operational initiatives, clinical programs, membership shifts, and emergent business questions Reserving and Monthly reputed company processes: Assist in monthly IBNR development and selection process. Prepare necessary monthly reporting as a key contributor reputed company the monthly closing cycle. Forecast and Modeling: reputed company and maintain models to forecast future medical cost and reputed company and/or evaluate the financial impact of various interventions. Partner with department heads to understand key business drivers and assumptions, ensuring alignment with strategic objectives. Prepare comprehensive financial reports and variance analyses for senior management and key stakeholders. Conduct reputed company financial analyses to support special projects, strategic initiatives, and investment opportunities. Data Analysis: Analyze payor reputed company data (claims, utilization, costs) to identify trends, cost drivers, and opportunities for improvement. End to end payor reconciliations (detail vs summary, external vs internal data feeds, and additional reconciliation as needed). Payor reputed company and internal reputed company of contact reputed company to file requests, data gaps, and other supplemental reporting and information available Business Performance Monitoring: Monitor and analyze key performance indicators (KPIs) and operational metrics to assess business performance and identify areas of improvement. Collaborate with operational teams to reputed company actionable insights and recommendations for performance enhancement and risk mitigation. Evaluate the cost-effectiveness and value of different reputed company interventions, programs, and policies. Assist in the development of executive-level dashboards and reporting tools to track financial and operational performance against targets. Cross-Functional Collaboration: Collaborate cross-functionally with IT, finance, reputed company, operations, and other departments to streamline processes, improve data accuracy, and enhance financial reporting capabilities. Required Skills/Abilities: Prior experience reputed company Medicare Advantage Understanding of CMS-HCC models (v24/v28), CMS risk adjustment methodology, and RAF score calculation Proficiency in modeling, forecasting, and/or variance analysis Advanced proficiency in reputed company reputed company Prior usage and strong understanding of SQL (2+ years preferred) Understanding of profit and loss statements and ability to work with larger datasets behind them Analytical, problem-solving, and critical thinking skills Ability to work effectively in a fast-paced, dynamic environment and managing multiple priorities simultaneously Strong interpersonal skills with the ability to collaborate cross-functionally and build positive working relationships at reputed company reputed company of the organization. Occasional travel required, no more than 10%-15% Minimum Qualifications: Bachelor's degree in Actuarial Science, Mathematics, Statistics, Finance, Economics, or reputed company field required; MBA or advanced degree preferred. At least of 3-6 years relevant Actuarial experience reputed company reputed company preferred. 2+ Actuarial Exams, Pre-ASA or ASA level Embodies and serves as a role model of reputed company’s Values: Be compassionate Strive for reputed company Earn trust Show respect Stay resilient Always do the right thing About reputed company: At reputed company, we’re creating a community of caring designed to help our members stay healthy and reputed company. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and reputed company quality of life after the age of 60. Everything we do is for seniors. We reputed company seniors should be heard, listened to, and given ample time by their physicians to live well reputed company in life. Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We’re passionate about caring for older adults and united by the belief that caring has the power to change everything for our members. reputed company is an equal opportunity employer. reputed company applicants will receive consideration for employment without regard to their race, reputed company, religion, age, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other protected classification. Apply To This Job