Senior Actuarial Support Analyst

Cohere Health
$105,000 - $115,000Remote

About The Position

We are looking for a detail-oriented Senior Actuarial Support Analyst to join our Actuarial team. In this role, you will be responsible for evaluating cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process. The ideal candidate will have extensive experience in healthcare analytics, financial modeling, and prior authorization, along with a strong strategic mindset and data-driven problem-solving skills. The work will be fast-paced and project-based, with evolving needs - requiring curiosity, flexibility, and grace under pressure. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Actuarial team and develop & maintain cost savings models. This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.

Requirements

  • 5 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting,
  • Proficiency in data analytics and visualization tools, for example SQL, Tableau, Power BI, advanced Excel,
  • Strong understanding of healthcare cost drivers and medical claims data,
  • Demonstrated experience in data cleaning, data analysis and problem-solving skills,
  • Ability to transform complex data into actionable insights and clear, concise reports.

Nice To Haves

  • Familiarity with prior authorization, utilization management processes
  • Proficient in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark)
  • Experience with prior authorization & utilization management data.

Responsibilities

  • Design and maintain complex financial models to track and analyze cost-saving initiatives, providing regular updates and insights to senior leadership and stakeholders.
  • Perform advanced data analysis to assess prior authorization & claims trends, decision patterns, and cost drivers.
  • Lead the design and development of financial models to quantify the impact of proposed cost-saving initiatives and forecast cost reduction outcomes for business cases.
  • Use statistical and data visualization tools to identify trends, patterns, and anomalies in claims data that may indicate areas for improvement on savings.
  • Prepare detailed and executive-level reports and presentations that summarize cost-saving achievements, project performance, and future cost-saving potential.
  • Act as a trusted advisor to leadership and key internal & external stakeholders, providing strategic insights, recommendations, and guidance on cost-saving strategies.
  • Work closely with clinical and customer success teams to understand authorization challenges, provide analytical insights, and offer actionable recommendations to resolve issues.
  • Lead post-implementation assessments to measure the impact of cost-saving initiatives, ensuring continuous refinement and long-term sustainability of improvements.

Benefits

  • Medical, dental, vision, life, disability insurance, and Employee Assistance Program
  • 401K retirement plan with company match; flexible spending and health savings account
  • Flex Time Off + company holidays
  • Up to 14 weeks of paid parental leave
  • Pet insurance
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