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 Responsibilities Revenue & Risk Adjustment Analytics Build and refine models to estimate risk-adjusted revenue across Medicare Advantage populations Analyze risk score performance, coding completeness, and underlying drivers of RAF variability Assess the financial implications of regulatory changes, including updates to CMS risk adjustment methodologies Partner with internal stakeholders to evaluate revenue impacts tied to operational initiatives, membership changes, and clinical programs Contribute to budgeting cycles, forecasting updates, and variance analysis tied to revenue performance Forecasting & Financial Modeling Develop forward-looking projections for medical cost and revenue to support planning and decision-making Align modeling assumptions with business strategy through collaboration with clinical, operational, and finance leaders Deliver financial reporting packages and summarize key insights for leadership audiences Support strategic analyses, investment decisions, and enterprise initiatives through ad hoc modeling Reserving & Financial Close Support Assist in estimating and monitoring reserves, including IBNR development and evaluation Contribute to monthly close processes through reporting, reconciliation, and variance explanation Maintain consistency and accuracy across financial datasets used in reporting cycles Data & Performance Analysis Analyze healthcare data (e.g., claims, utilization, cost trends) to identify performance drivers and improvement opportunities Perform data validation, reconciliation, and integration across multiple internal and external sources Act as a liaison for data-related inquiries, working with external payors and internal stakeholders as needed Operational & Business Insights Track key financial and operational indicators to assess organizational performance Identify inefficiencies and recommend actions to improve financial outcomes and mitigate risk Evaluate the economic impact and effectiveness of clinical programs, population health initiatives, and care models Support the development of dashboards and reporting tools to improve visibility into KPIs Cross-Functional Collaboration Partner with teams across finance, accounting, operations, and technology to improve data flows and reporting accuracy Communicate analytical findings clearly to both technical and non-technical stakeholders Contribute to process improvement initiatives to enhance scalability and efficiency Qualifications Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field 3-6+ years of actuarial experience in healthcare, with exposure to Medicare Advantage strongly preferred Progress toward actuarial credentials (ASA or pre-ASA with multiple exams completed) Strong understanding of CMS risk adjustment frameworks and RAF score mechanics Experience working with financial statements, forecasting models, and large healthcare datasets Technical Skills Advanced Excel proficiency for modeling and analysis Experience with SQL or similar tools for data extraction and manipulation Familiarity with actuarial modeling, forecasting techniques, and variance analysis