Senior Actuarial Analyst - Heath Plan

Job description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. The Job The Senior Actuarial Analyst contributes to the success of the Actuarial team by preparing and analyzing data for network contract modeling, identifying opportunities to improve model efficiency, and supporting effective communication with network team. Senior Actuarial Analysts typically have several years of experience in the field and may also be involved in mentoring and training junior analysts. You Will Use tools that currently exist support provider contract negotiations for globally capitated and shared risk providers. Support to include financial modeling, DOFR valuations (internal claims extraction / analysis and external research), health care cost trend, risk analysis, and advice / guidance to the Network Management and Contracting teams. Develop ad hoc provider claims modeling and analysis for fee-for-service provider negotiations. Financial analyses may incorporate Medicare fee schedules and potentially repricing. Support ad-hoc analytics such as product development, and other customized projects to suit business needs. Utilize the Data Warehouse efficiently to develop reports and extract data fields. Assist the actuarial team with the development of Medicare Advantage bid by keeping track of network assumptions and scenarios. Proactively identify opportunities to streamline workflows, enhance model efficiency, and improve automation of existing processes. Bring intellectual curiosity and a continuous improvement mindset to all assigned work, challenging the status quo where appropriate. We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned. Your Qualifications Bachelor's Degree in Actuarial Science, Mathematics, or Statistics or any other major with significant quantitative course work is required. 3+ years of healthcare actuarial, healthcare economic, or healthcare finance experience; or comparable consulting experiences. Experience with provider contract modeling and Medicare FFS structure. Certifications deemed to be reasonable to function at this level. Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter. May provide leadership, coaching, and/or mentoring to a subordinate group. Advanced Analytical Skills: Proficient in using statistical and mathematical models to analyze complex data sets, identify trends, and make informed predictions. Technical Proficiency: Expertise in actuarial software and tools such as Excel, SQL, and specialized actuarial modeling software. Communication and Collaboration: Strong ability to communicate technical information clearly to non-technical stakeholders and work effectively in cross-functional teams. Microsoft Office Suite (Word, Excel including formulas, V-Lookups, and pivot tables, PowerPoint, Access, Outlook, Teams), and SQL at advance level is required. What's in it for you? Base salary range: $90,000 to $120,000 per year Internal title: Actuarial Analyst Sr Work Mode: Mostly Remote An annual employee bonus program Robust Wellness Program Generous paid-time-off (PTO) Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday Excellent 401(k) Retirement Saving Plan with employer match and contribution Robust employee recognition program Tuition reimbursement An opportunity to become part of a team that makes a difference to our members and our community every day! We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now! At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-MS1 #LI-Hybrid Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)