Director of Actuarial Analytics and Insights
United States - Remote
R
USD 130K-219K (estimate) Executive-level Full Time
Tasks
- Analyze medical loss ratio drivers
- Analyze utilization trends
- Build forecasting and accrual models
- Build member level actuarial models
- Build population health metrics
- Communicate model methodology and results
- Design dashboard analytics logic
- Develop HCC capture and recapture analytics
- Develop medical economics models
- Estimate midyear and final settlement
- Maintain risk adjustment performance models
- Model risk adjustment audit exposure
- Partner to align analytics with quality initiatives
- Present analytics to executive audiences
- Prioritize chart review and coding efforts
- Reconcile RAF calculations with CMS source files
- Support ACA rate filings
- Support Medicaid capitation analytics
- Support Medicare Advantage bid pricing
- Support value based contract analytics
Perks/Benefits
Skills/Tech-stack
Accrual Modeling | Audit Readiness | CMS-HCC | Chart Review Prioritization | Chart review | Data Modeling | Encounter Data | Excel VBA | Forecasting | HCC Capture | ICD10 | Loss Ratio | Medical economics | Medical loss ratio | Microsoft Access | Microsoft Excel | Power BI | Python | R | RAF score calculation | Risk adjustment | SAS | SQL | Statistical modeling | Tableau | Utilization analysis
Education
Bachelor of Engineering | Bachelor of Science | Master of Science
Roles
Actuarial Analyst | Actuary | Analyst | Analytics | Analytics Director | Director | Risk Adjustment Analyst
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