Senior Actuarial Analyst

Altais

7d

About The Position

At Altais, we’re on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We help physicians focus more on patient care and less on paperwork through smarter technology, purpose-built tools, and a team-based model of care. Our network includes Brown & Toland Physicians, Altais Medical Group, and Family Care Specialists. Together, we’re building a more connected, physician-first healthcare system. About the Role Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients. Actuarial analyst III is an expert on delivering Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. This role conducts complex revenue analysis including pricing, quality performance and actuarial best estimate, complex analysis in support of payer and provider negotiations and medical cost management strategies. The actuarial role is the lead in partnering with multi-faceted departments providing high level business intelligence and analytics requirements of varying disciplines. Advance skills in statistical analysis, reporting cycle, project management, customer service and consultative skills are critical to the success of this position.

Requirements

• Bachelor’s degree in quantitative discipline such as accounting, engineering, economics, finance, statistics, or mathematics from an accredited program or similar
• 5 or more years of experience working with data and actuarial models.
• 5 or more years working with managed care application like GE Centricity, Epic, Cerner etc.
• 5 or more years of experience in the healthcare industry either working in a hospital, health plan or managed care environment preferred.
• 5 or more years of experience in financial modeling in payer and provider negotiations and medical cost management strategies.
• 5 or more years of experience in working in rapid cycle, decision support role in a very dynamic environment.

Responsibilities

• Generate and distribute routine reports to support risk adjustment actuarial best estimate calculation and financial reporting.
• Extract and compile information from various systems to support executive decision-making.
• Research and develop reports and analysis for senior management; effectively communicate results.
• Assist in the preparation of forecasts/filings related to risk adjustment.
• Developing risk score reporting with Cozeva, internal claims and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision support, and communicating findings.
• Collaborate with operational staff to analyze, understand, modify, and communicate models and results.
• Make recommendations to management based on relevant findings.
• Utilizes Power BI to display relevant reporting within a refresh cycle.
• Analyzes key trends and performance related to clinical programs, provider network performance, other programs or practices, and providers of health care.
• Peer review and train junior level actuarial analyst including prioritization of work and projects.

What This Job Offers

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