Actuarial Analyst III (Government Programs Trend & AI)

Horizon Healthcare Services•Newark, NJ

23d

About The Position

This senior-level position in the Actuarial Department focuses on Government Programs trend forecasting, including Medicare, PDP, DSNP, and Medicaid. The analyst applies actuarial principles, mathematical modeling, and statistical analysis to support risk evaluation and sound business and pricing decisions. Responsibilities include supporting forecasted trends, evaluating benefit and cost-sharing changes, conducting pricing studies, assessing state and federal legislative and regulatory changes, and contributing to actuarial initiatives. The role also serves as a key AI integration partner for actuarial trend work. It identifies and shapes business-grounded AI use cases, delivers small-scale AI solutions, supports adoption and effective use, monitors outcomes, and escalates misalignment or stalled progress. The analyst collaborates with internal and cross-functional stakeholders and communicates findings and recommendations to management. Horizon employees must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware. The listed salary range is $87,300–$119,070. Compensation decisions may consider education, experience, licensure, certifications, geographic location, and internal equity.

Requirements

Bachelor’s degree required; preferably in Actuarial Science, Mathematics, Statistics, Economics, Data Science, or a related quantitative field.
At least 4 years of actuarial, statistical, healthcare analytics, or related experience.
Advanced proficiency in Microsoft Excel.
Practical working-level knowledge of artificial intelligence concepts, tools, and platforms, including generative AI, large language models, prompt engineering, AI assistants, and low-code/no-code AI development tools.
Strong analytical, mathematical, and statistical problem-solving skills.
Excellent verbal and written communication skills, including the ability to present complex information clearly and effectively.
Demonstrated critical thinking, sound judgment, attention to detail, and problem-solving ability.
Ability to work independently and manage multiple priorities in a deadline-driven environment.
Strong mathematical skills and statistical analysis abilities.

Nice To Haves

Progress toward the Associate of the Society of Actuaries (ASA) designation; ASA certification is preferred.
Health insurance, healthcare, or managed care experience.
Experience with SAS, SQL, R, Python, or similar analytical/programming tools.
Working knowledge of actuarial concepts, data analysis, and statistical methodologies.

Responsibilities

Assist in developing forecasted trends.
Evaluate proposed benefit and cost-sharing changes and assess their financial impact.
Conduct pricing analyses and studies for product lines of business.
Analyze the impact of proposed state and federal legislative and regulatory changes.
Conduct experience studies and detailed analyses to identify cost drivers, utilization patterns, and emerging trends.
Identify, shape, and document AI use cases with business unit stakeholders, ensuring opportunities address business needs and align with business unit strategy.
Support and drive AI adoption and utilization within the business unit.
Support additional actuarial projects and initiatives as assigned.
Collaborate with internal stakeholders and incorporate feedback from cross-functional business partners.
Prepare reports and presentations communicating findings, recommendations, and key insights to management.
Complete ad hoc modeling, forecasting, and analytical projects as needed.
Deliver small-scale AI solutions, monitor adoption outcomes, and escalate misalignment or stalled progress.