Senior Actuarial Analyst

Q Point Health LLC

5h • Remote

About The Position

The Senior Actuarial Analyst is responsible for leading advanced actuarial analytics and health economics evaluations that measure financial and clinical outcomes across organizational programs. This role expands upon core actuarial responsibilities by owning the design and execution of affordability analyses and ROI studies, particularly within Medicaid populations and value-based care arrangements.

This individual will translate complex clinical and operational interventions into financial impact, develop methodologies for savings attribution, and provide strategic insights that influence payer performance, product strategy, and enterprise decision-making.

Requirements

• Bachelor’s degree in Mathematics, Statistics, Actuarial Science, Economics, or related field (or equivalent experience).
• 3-5+ years of healthcare analytics or actuarial experience.
• Strong experience with Medicaid data, including claims, encounters, eligibility, and capitation structures.
• Demonstrated experience in ROI analysis, health economics, or program evaluation.
• Advanced proficiency in SQL and Excel; experience with Python, R, or SAS preferred.
• Strong understanding of healthcare financial metrics (PMPM, MLR/MCR, risk scores) and utilization drivers.
• Experience working in value-based care or risk-based contracting environments.
• Strong communication skills with ability to present complex analyses to diverse audiences

Nice To Haves

• Progress toward ASA
• Experience with causal inference or quasi-experimental methods (e.g., difference-in-differences, matching).
• Familiarity with Medicaid rate setting, risk adjustment models (e.g., CDPS), and regulatory environment.
• Demonstrated ability to manage multiple projects and operate independently in fast-paced environments.
• Strong systems thinking with ability to connect clinical programs to financial outcomes.

Responsibilities

• Develop and enhance actuarial and health economic models to quantify program impact on cost, utilization, and quality outcomes.
• Own monitoring and evaluation of payer/provider-group performance across financial (MLR/MCR, PMPM) and operational/utilization metrics.
• Translate performance results into actionable insights and recommendations to improve value-based contract outcomes.
• Support payer reporting and partner discussions with clear, defensible financial analyses.
• Leverage and integrate multiple data sources (claims, eligibility, pharmacy, EMR, quality, care management) to produce comprehensive analyses
• Identify key cost drivers, population health trends, and intervention opportunities, particularly within Medicaid populations.
• Investigate and resolve complex data anomalies; establish best practices for data validation and reliability.
• Translate analytical findings into executive-ready insights and narratives for internal and external stakeholders.
• Continuously improve processes for scalability, automation, and reproducibility of analyses.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior