The Role
Own actuarial contract modeling for Medicare Advantage, Medicaid, and Commercial payer agreements. Build financial models, dashboards, and reporting infrastructure; analyze contract performance and financial impacts; support payer negotiations; monitor reimbursement, legislation, market, and risk-adjustment trends; and provide cross-functional insights across finance, analytics, contracting, and operations.
Summary Generated by Built In
We are seeking an Actuarial Senior Analyst to help drive the financial analytics behind our payer contracts. This role will own contract modeling across our MA, Medicaid, and Commercial business. You'll build models from scratch, track contract performance, and support payer negotiations. This role will report to the Senior Manager, Actuary and is open for remote work.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Strategic Deal Modeling: Craft sophisticated deal models to support contract negotiations with health plans, ensuring favorable terms and optimal outcomes.
- Data-Driven Insights: Utilize data and analytics to provide consultative support, driving financial and operational performance improvements for our health plan contracts.
- Financial Impact Analysis: Employ advanced data tools to track, analyze, forecast, and report on the financial impact of payer contracts.
- Infrastructure Development: Build robust analytical infrastructure, including comprehensive reports and dashboards, to monitor payer financial performance.
- Market Trend Monitoring: Stay ahead of industry developments researching topics such as changes in legislation, market share, Star Ratings, bid strategies, and reimbursement trends.
- Ad Hoc Analysis: Conduct a variety of analyses related to benchmarking, contract optimization, investor relations, risk adjustment, and more.
- Cross-Functional Collaboration: Work closely with teams across Reserving, Analytics, Data, Finance, M&A, Contracting, Medical Economics, and Operations.
Qualifications
- FSA or ASA credentials or near attainment of ASA credentials.
- 3+ years of experience in actuarial roles.
- 1+ years of experience in VBC or VBC adjacent roles.
- Advanced knowledge of Microsoft Excel.
- Intermediate knowledge of SQL.
- Champion of independent critical thinking, unafraid to challenge the status quo and explore innovative solutions.
- Proficiency and desire to build actuarial models from scratch.
- Comfortable working on a small team in a fast-paced environment.
Preferred Qualifications:
- Knowledge in health plan reimbursement methodologies.
- Experience working on the provider side of healthcare.
- Experience in Medicare Advantage bid mechanics.
- Risk adjustment experience.
- Experience in the California healthcare market.
- Understanding of the actuarial continuum (both pricing/forecasting and valuation/reserving).
Environmental Job Requirements and Working Conditions
- This position has the option to be remotely based in the U.S. Conversely, candidates can choose to work in a hybrid fashion and work through the Alhambra, CA, Las Vegas, NV, or Houston, TX Astrana Health offices.
- The hiring manager for this role sits in the Eastern Time Zone, while many of the business partners work on Pacific Time.
- The total compensation target pay range for this role is: $100,000 – $135,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
- Astrana Health offers a competitive Actuarial Student Program for any candidate seeking their ASA or FSA credentials.
About
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Skills Required
- FSA or ASA credentials, or near attainment of ASA credentials
- 3+ years of experience in actuarial roles
- 1+ years of experience in value-based care or adjacent roles
- Advanced knowledge of Microsoft Excel
- Intermediate knowledge of SQL
- Independent critical thinking and willingness to challenge the status quo
- Ability and desire to build actuarial models from scratch
- Comfort working on a small team in a fast-paced environment
- Knowledge of health plan reimbursement methodologies
- Experience working on the provider side of healthcare
- Experience with Medicare Advantage bid mechanics
- Risk adjustment experience
- Experience in the California healthcare market
- Understanding of pricing, forecasting, valuation, and reserving
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The Company
What We Do
Astrana Health is a physician-centric, technology-powered healthcare company that operates an integrated delivery platform. It enables providers to participate in value-based care arrangements, helping them deliver accessible, high-quality, and cost-effective care to patients. The company provides care coordination services to patients, primary care physicians, specialists, and health plans, leveraging proprietary technology to streamline operations and improve patient outcomes across local communities.
