Sr Actuarial Analyst

The Senior Actuarial Analyst will play a key role in shaping ConcertoCare’s continued growth by building actuarial models and studies that guide decision-making across pricing, forecasting, and value-based care contract performance. This is an exciting opportunity for someone who enjoys turning complex, imperfect data into meaningful insights and partnering with market, clinical, and finance leaders to drive impact. The person in this role will help strengthen how we measure performance, support strategic decisions, and contribute to our expansion across the country.

Responsibilities may include:

Medical Expense Reporting:

• Design and perform actuarial studies and reports related to medical costs, risk scores, revenue, and membership, develop strong visuals and key insights to support deliverables to executive leadership
• Analyze results to identify early signs of adverse trends or other issues related to medical care costs and premium based revenue
• Work in collaboration with IT to optimize data ingestion and reconciliation to ensure data accuracy

Forecasting and Analytic Analysis:

• Inform the financial forecast with actuarially-sound studies to enhance accuracy
• Analytic support to explain variation from forecasted outcomes and collaborate with adjacent teams to recommend changes to optimize results

Pricing and Underwriting:

• Contributing strong recommendations on how to best measure program impacts with use of historic and predictive analytics.
• Support Finance in business development discussions, contributing strong recommendations on how to best structure risk-sharing arrangements through a combination of historic and predictive analytics.

Model Building and Development:

• AI experience: extra consideration given to candidates who have demonstrated effective use of AI tools
• Work with IT partners to create reporting in analytic tools such as Power BI. Understand both technical and business need to create stellar reporting that answers important business questions.

Performance Measurement:

• Perform analytics and reporting on existing and new programs.
• Conduct studies on the value of existing and potential interventions and clinical programs – both to optimize our clinical models, as well as for use in marketing materials.
• Enhance predictive analytics and proprietary clinical algorithms to optimize outcomes.

Our ideal candidate can:

• Apply a healthy balance of creative thinking and actuarial discipline in the development of core actuarial processes and analytics.
• Identify overall drivers of emerging results and communicate clearly and succinctly to a non-technical audience.
• Develop and maintain strong working relationships with key stakeholders including market leadership, physician and clinical operations leadership, IT, the revenue optimization team, and finance peers.
• Ready to build new tools and capabilities in a new organization; show great initiative combined with the knowledge of when to ask for guidance.
• Manage several fast-paced projects with an ability to produce quality materials within tight timeframes.
• Integrate actuarial industry standards and external trend information to help ConcertoCare develop prospective and target performance levels.
• Data engineer skill set: identifying root causes and data quality issues and working collaboratively with IT on fixes.

Qualifications:

• Bachelor’s degree in actuarial studies, statistics, or related field preferred.
• Progress towards Associate of the Society of Actuaries (ASA).
• 2-5 years of experience in the healthcare actuarial field with a strong understanding of health insurance product design (ideally Medicare and Medicaid), reserving/forecasting, Medicare bid pricing.
• Value-based contracting modelling experience strongly preferred.
• Experience in Government health care contracts preferred (Medicare and Medicaid).
• Proficient in Excel, Databricks, SQL, SAS or other coding language.
• AI experience: extra consideration given to candidates who have demonstrated effective use of AI tools.

Base Salary/ Wage Range $90,000 to $110,000 plus annual bonus. Compensation for the role is commensurate with the candidate’s qualifications, skills, competencies, and experience and may fall outside of the range shown. ConcertoCare offers a competitive total rewards package, which includes full healthcare coverage, a 401K with match, and a broad range of other health, wellness, and financial benefits.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.