Senior Actuarial Analyst - Medicare Advantage

A growing healthcare organization is seeking a Senior Actuarial Analyst to support financial strategy and performance across its Medicare Advantage business. This role will serve as a key partner to leadership by delivering actionable insights, enhancing forecasting capabilities, and strengthening financial visibility across core operations. The position offers a blend of actuarial modeling, financial analysis, and cross-functional collaboration, with a strong emphasis on revenue optimization and business performance monitoring. Key ResponsibilitiesRevenue & Risk Adjustment AnalyticsBuild and refine models to estimate risk-adjusted revenue across Medicare Advantage populationsAnalyze risk score performance, coding completeness, and underlying drivers of RAF variabilityAssess the financial implications of regulatory changes, including updates to CMS risk adjustment methodologiesPartner with internal stakeholders to evaluate revenue impacts tied to operational initiatives, membership changes, and clinical programsContribute to budgeting cycles, forecasting updates, and variance analysis tied to revenue performance Forecasting & Financial ModelingDevelop forward-looking projections for medical cost and revenue to support planning and decision-makingAlign modeling assumptions with business strategy through collaboration with clinical, operational, and finance leadersDeliver financial reporting packages and summarize key insights for leadership audiencesSupport strategic analyses, investment decisions, and enterprise initiatives through ad hoc modeling Reserving & Financial Close SupportAssist in estimating and monitoring reserves, including IBNR development and evaluationContribute to monthly close processes through reporting, reconciliation, and variance explanationMaintain consistency and accuracy across financial datasets used in reporting cycles Data & Performance AnalysisAnalyze healthcare data (e.g., claims, utilization, cost trends) to identify performance drivers and improvement opportunitiesPerform data validation, reconciliation, and integration across multiple internal and external sourcesAct as a liaison for data-related inquiries, working with external payors and internal stakeholders as needed Operational & Business InsightsTrack key financial and operational indicators to assess organizational performanceIdentify inefficiencies and recommend actions to improve financial outcomes and mitigate riskEvaluate the economic impact and effectiveness of clinical programs, population health initiatives, and care modelsSupport the development of dashboards and reporting tools to improve visibility into KPIs Cross-Functional CollaborationPartner with teams across finance, accounting, operations, and technology to improve data flows and reporting accuracyCommunicate analytical findings clearly to both technical and non-technical stakeholdersContribute to process improvement initiatives to enhance scalability and efficiency QualificationsBachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field3-6+ years of actuarial experience in healthcare, with exposure to Medicare Advantage strongly preferredProgress toward actuarial credentials (ASA or pre-ASA with multiple exams completed)Strong understanding of CMS risk adjustment frameworks and RAF score mechanicsExperience working with financial statements, forecasting models, and large healthcare datasets Technical SkillsAdvanced Excel proficiency for modeling and analysisExperience with SQL or similar tools for data extraction and manipulationFamiliarity with actuarial modeling, forecasting techniques, and variance analysis