Own and maintain client-facing reporting that measures cost savings, outcomes, and performance of prior authorization programs across specialty areas.
Build, maintain, and QC actuarial models and methodology behind that reporting, keeping them ready to scale to new clients and lines of business.
Analyze and interpret authorization and claims data to identify trends, key drivers, and opportunities to improve customer value, quantifying the dollar and utilization effect of each.
Design and maintain complex financial models to track cost-saving initiatives and provide insights.
Perform advanced data analysis to assess prior authorization trends, claims trends, and cost drivers.
Lead post-implementation assessments to measure the impact of cost-saving initiatives and ensure sustainability.
Cohere Health's clinical intelligence platform and agentic AI-powered solutions optimize the speed, cost, and quality of care. The company is a growing organization with a supportive, growth-oriented environment and has been recognized as a top startup.
Design, build, and deploy scalable actuarial models like IBNR and risk adjustment into platform APIs.
Collaborate with product and engineering teams to inform domain context for our AI suite.
Embed rigorous actuarial best practices into automated tools and data pipelines.
Arbital Health is a healthcare technology and actuarial leader that centralizes, measures, and adjudicates value-based care contracts at scale. The company is rapidly growing, backed by leading investors, and values high-potential, humble individuals in a fast-paced environment.
Cultivate deep understanding of clinical content and UM products to drive program effectiveness.
Lead clinical analytics projects with multi-disciplinary partners to build analytical solutions.
Independently conduct in-depth analyses using statistical modeling and data mining on healthcare data.
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. The company works with over 660,000 providers and handles over 12 million prior authorization requests annually.
Review offeror proposals for completeness, consistency, and mathematical accuracy.
Develop and maintain analytical models and evaluation workpapers.
Collaborate with pricing and actuarial professionals to reconcile data and assumptions.
The partner company supports government acquisition and proposal evaluation through rigorous pricing, actuarial, financial, and healthcare analysis. The team culture emphasizes analytical rigor, quality control, and collaboration in a remote environment.
Perform data management activities to generate analytic-ready datasets using SQL and/or SAS.
Perform descriptive and basic statistical analysis using large patient and claims databases.
Contribute to the development of concept proposals, scope of work, and analysis plans.
Avalere Health is a healthcare advisory firm focused on ensuring every patient is identified, treated, supported, and cared for. The company has a global team with major hubs in London, Washington DC, and New York, and fosters an inclusive culture with six Employee Network Groups.
Develop and maintain operational, clinical, quality, compliance, and executive dashboards supporting the LTSS program.
Transform complex healthcare, operational, and financial data into actionable insights for program oversight and improvement.
Partner with cross-functional teams to monitor performance indicators, support compliance, and drive data-informed decisions.
The hiring partner is a healthcare organization supporting a large-scale Long-Term Services and Supports (LTSS) program. The role offers substantial autonomy and cross-functional collaboration in a fully remote environment.
Analyze complex healthcare claims and eligibility data to identify trends, anomalies, and opportunities for improvement.
Develop and maintain dashboards using Tableau, Power BI, or QlikView to provide clear insights for business decisions.
Collaborate with cross-functional teams to translate business questions into analytical solutions and present findings to non-technical audiences.
This company specializes in healthcare data analytics, turning complex claims and eligibility data into actionable insights. The size and culture of the organization are not disclosed in the posting.
Own the data methodology and carry derived data points through development, QA, and production into metrics and categories.
Validate numbers using reconciliation SQL, version-over-version comparisons, and impact analysis before logic changes ship.
Turn feature requests from product and customer teams into delivered analytics by scoping, writing logic, and validating results.
Clarify partners with 60+ health systems to provide healthcare analytics and outcomes by mapping patient journeys and care economics. The company works with 300 million patient journeys and fosters a collaborative, impact-driven culture with a focus on mission and margin alignment.
Use statistical models and machine learning to analyze retention, churn, and customer lifetime value.
Collaborate with cross-functional teams including software engineers and product leaders to implement data-driven solutions.
Retrieve and manipulate large structured and unstructured data from various sources for analysis.
Mercury Insurance is an insurance company that helps people reduce risk and overcome unexpected events. They have been in business for over 60 years and are recognized as one of America's Best Midsize Employers, fostering a culture of teamwork and inclusion.
Partner with Medical Affairs to define KPIs and build dashboards for clinical outcomes.
Conduct exploratory analyses to identify trends and recommend improvements.
Collaborate with data science, product, and engineering teams to ensure data access and integrity.
Spring Health is a global mental health company using an AI-native platform to eliminate barriers to mental health care. They serve over 170 million people worldwide through employers and health plans, with a culture focused on innovation and using AI tools to enhance care.
Analyze complex healthcare and quality data to identify trends and performance improvement opportunities.
Develop reports, dashboards, and visualizations to communicate findings to stakeholders and leadership.
Partner with cross-functional teams to refine analytical requirements for HEDIS, population health, and quality initiatives.
Jobgether uses AI-powered matching to connect candidates with hiring companies. They focus on efficient and objective application reviews, sharing top-fitting candidates directly with employers.
Own Virta's actuarial and financial value strategy, translating clinical outcomes into credible and compelling ROI.
Design performance guarantees and risk arrangements that balance client value with responsible financial risk.
Shape product and commercial strategy with Commercial Leadership, Product Marketing, Sales, and Customer Success.
Virta Health reverses metabolic disease in one billion people through technology, personalized nutrition, and virtual care delivery. The company has raised $350M+ from top investors and partners with health plans and employers to restore health.
Lead the MA Plan Command Center, setting direction and operating standards for governance, initiative portfolio management, and executive reporting.
Own enterprise performance monitoring frameworks, dashboards, and KPIs to identify risks and guide leadership decisions.
Integrate financial, actuarial, and operational insights into clear recommendations for executive leadership, leveraging AI-enabled analysis.
We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. Our team is composed of passionate, mission-driven individuals with diverse expertise, working together to solve healthcare challenges.
Leverage actuarial and data science expertise to build, validate, and operationalize analytical solutions for commercial P&C insurance.
Collect, integrate, and analyze complex datasets using Python, SQL, and visualization tools like Tableau and Power BI.
Collaborate with engineers and stakeholders to deploy analytics on Azure Databricks, driving smarter business decisions.
EPIC Insurance Brokers & Consultants is a leading insurance brokerage and consulting firm delivering risk management, employee benefits, and commercial insurance solutions. With over 4,000 employees nationwide and a growth-driven culture rooted in owner mindset, inspire trust, think big, and drive results, they foster collaboration and innovation.
Apply actuarial knowledge to life insurance valuation, supporting LDTI and PBR standards.
Prepare and analyze monthly and quarterly valuation deliverables, developing tools for validation.
Collaborate with cross-functional partners in Tax, Controllership, Pricing, and other areas to support business objectives.
Nationwide is a Fortune 100 insurance and financial services company with nearly $70 billion in annual sales. They have a caring culture and have been recognized as one of the Fortune 100 Best Companies To Work For.
Execute recurring weekly and monthly sales reports, dashboards, and analyses, delivering accurate and timely results.
Improve and automate recurring deliverables to spend less time producing reports and more time interpreting them.
Build and refine sales forecasting, including pipeline, capacity, and target-setting analysis in partnership with sales leadership.
Koalafi makes it easier for people to pay for big purchases over time by offering flexible lease-to-own financing to non-prime consumers. With 200+ teammates, they provide challenging work and a culture of innovation, trust, and ownership.
Own the rate indication process for home and auto, including quarterly updates and communication.
Execute the annual rate plan across every state and line, working closely with Product.
Lead and develop a team of actuarial professionals, managing performance and career growth.
Branch is on a mission to make insurance more accessible by using data, tech, and automation to simplify insurance. They are a remote-first company with a preference for candidates in Ohio, and offer a culture of autonomy and speed.
Design and execute analytical studies, protocols and methods
Perform descriptive and advanced statistical analysis using large patient and/or claims databases
Develop and author study reports and publications
Avalere Health is a healthcare advisory firm focused on ensuring every patient is identified, treated, supported, and cared for. They have a global team with offices in major cities and a culture that emphasizes inclusion, flexibility, and professional growth.
Collaborate with a small team of modelers to design, develop, and implement underwriting risk models for Global Risk Solutions.
Build and maintain statistical models, validate parameterization, and communicate results to stakeholders across underwriting and actuarial functions.
Use large data sets and advanced analytical methods to drive insights into line-of-business dynamics and improve risk analytics tools.
Global Risk Solutions is a leading provider of commercial, specialty insurance, and reinsurance products worldwide. The team is a small, collaborative group focused on risk modeling, with an inclusive culture that values diverse perspectives, professional development, and employee well-being.
Perform advanced analysis and interpretation of Medicaid data, developing methodologies to support program oversight.
Analyze large datasets to identify patterns, anomalies, and high-risk areas for fraud, waste, and abuse.
Create data visualizations and dashboards that communicate complex findings to technical and non-technical audiences.
This partner company provides advanced data analytics solutions for public-sector healthcare programs, focusing on Medicaid integrity. They foster a collaborative, mission-driven culture with a multidisciplinary team of analysts and technical experts.