Senior Actuarial Analyst

Bon Secours Mercy Health; Philippines; Hybrid; PHP 1,200,000 - 2,000,000; Full time

Benefits offered by this job

HMO coverage

Retirement plan

Life insurance

Work-from-home allowance

Connectivity allowance

Wellness allowance

Paid vacation

Sick leave

SSS/PhilHealth/Pag-IBIG benefits

Flexible working model

Culture and events

Learning and development

Office engagement

Job summary

Bon Secours Mercy Health Global Business Services - Manila is seeking a Senior Actuarial Analyst to deliver advanced financial and data analysis for value-based managed care contracting and payer strategy.

The role supports cross-functional collaboration across U.S. healthcare operations, with responsibilities spanning financial modeling, contract performance evaluation, reconciliation and data-driven insights for negotiation strategy and enterprise decision-making.

Qualifications

• 5+ years of experience in healthcare finance, payer analytics or related field.
• Experience supporting value-based contract development and performance tracking.
• Experience in financial forecasting, audit and predictive analytics.
• Proven ability to analyze large healthcare claims, reimbursement or performance datasets.
• Track record of delivering analytics that inform business decisions.

Responsibilities

• Analyze reimbursement structures and financial performance to support payer negotiations and strategy development.
• Design and evaluate value-based payment models including shared savings, risk arrangements and quality-based incentives.
• Develop financial models and pro forma analyses to assess contract changes and cost trends.
• Perform sensitivity and scenario analyses to estimate financial outcomes under various assumptions.
• Monitor contract and program performance to identify underpayments, compliance gaps and financial risks.
• Prepare monthly forecasts, performance reports and variance analyses for value-based programs.
• Conduct quarterly and annual reconciliation audits to validate payer compliance and contract performance.
• Investigate discrepancies and support dispute resolution related to payment variances.
• Build and enhance analytical tools to track healthcare trends and forecast performance.
• Translate data into actionable insights for payer negotiations and leadership decisions.
• Create executive-ready reports and data visualizations for clinical and financial stakeholders.
• Standardize and scale analytical processes across programs and contracts.
• Mentor analysts and provide technical guidance to improve output quality.
• Collaborate with cross-functional teams including finance, operations and clinical stakeholders.

Skills

Healthcare finance

Payer analytics

Financial modeling

Data visualization

SQL

Excel

Communication skills

Education

Bachelor's degree in Business Administration/Finance/Healthcare

Master's degree preferred

Tools

Power BI

Tableau

Job description

Who we are
At Bon Secours Mercy Health Global Business Services - Manila, we believe your best is yet to come. Based in the Philippines, we partner with U.S.-based teams to deliver strategic insights, operational excellence and specialized expertise that advance our Mission. Join a global team focused on meaningful healthcare impact.

Job Summary
The Senior Actuarial Analyst is responsible for delivering advanced financial and data analysis to support value-based managed care contracting and payer strategy. This role drives business impact through financial modeling, contract performance evaluation, reconciliation and data-driven insights that inform negotiation strategy and enterprise decision-making.
Operating within a Global Business Services environment, this role supports cross-functional collaboration, operational excellence and service delivery outcomes across U.S. healthcare operations.

What you'll do

• Analyze reimbursement structures and financial performance to support payer negotiations and strategy development
• Design and evaluate value-based payment models including shared savings, risk arrangements and quality-based incentives
• Develop financial models and pro forma analyses to assess contract changes, cost trends and performance opportunities
• Perform sensitivity and scenario analysis to estimate financial outcomes under varying cost and utilization assumptions
• Monitor contract and program performance to identify underpayments, compliance gaps and financial risks
• Prepare monthly forecasts, performance reports and variance analyses for value-based programs
• Conduct quarterly and annual reconciliation audits to validate payer compliance and contract performance
• Investigate discrepancies and support dispute resolution and appeals processes related to payment variances
• Build and enhance analytical tools and methodologies to track healthcare trends and forecast performance
• Translate complex data into actionable insights to support payer negotiations and leadership decision-making
• Create executive-ready reports and data visualizations for clinical and financial stakeholders
• Standardize and scale analytical processes across multiple programs and contracts
• Mentor analysts and provide technical guidance to improve team capabilities and output quality
• Collaborate with cross-functional teams including finance, operations and clinical stakeholders

Experience

• 5+ years of experience in healthcare finance, payer analytics, medical economics or related field required
• Experience supporting value-based contract development and performance tracking required
• Experience in financial forecasting, audit and predictive analytics required
• Proven ability to analyze large healthcare claims, reimbursement or performance datasets required
• Track record of delivering analytics that inform business decisions required

Education

• Bachelor's degree in Business Administration, Finance, Accounting, Healthcare Administration, Economics, Information Systems or related field required
• Master's degree in Business Administration, Healthcare Administration, Public Health, Finance or related field preferred

Certifications

• Certified Healthcare Financial Professional (CHFP) – Healthcare Financial Management Association preferred
• Certified Professional in Healthcare Quality (CPHQ) – National Association for Healthcare Quality preferred

Skills

• Strong knowledge of managed care contracts, payment methodologies and reimbursement analytics
• Advanced Microsoft Excel skills including financial modeling, PivotTables and scenario analysis
• Proficiency in data visualization tools such as Power BI or Tableau
• Working knowledge of SQL or similar data querying tools preferred
• Strong analytical thinking and problem-solving skills
• Ability to interpret complex contract terms and translate into financial impact
• Strong communication skills with ability to present technical data to non-technical audiences
• High attention to detail and ability to manage multiple priorities independently
• Ability to synthesize data from multiple internal and external sources to inform strategy
• Strong collaboration and stakeholder management skills
• Commitment to maintaining data confidentiality and compliance with healthcare standards

What we offer

• Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
• One-time Work From Home allowance, connectivity allowance and wellness allowance
• Paid vacation and sick leave
• Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
• Flexible working model based on role and business need
• Mission-driven culture events, outreach and service opportunities
• Learning and development programs, mentorship and career growth pathways
• Collaborative office spaces and engagement activities

Benefits may vary based on employment terms and role.