Actuarial Analyst II - Remote

Alignment Healthcare USA, LLC; Orange (CA); Remote; USD 78,000 - 117,000; Full time

Job summary

Alignment Health is seeking an Actuarial Analyst II to support Medicare Advantage pricing, forecasting, reserving, and risk adjustment. This remote role collaborates with Finance, Product, and Operations to translate data into actionable insights.

You will develop models, review claims and utilization data, prepare actuarial exhibits, and present findings to leadership. A Bachelor’s in a quantitative field and 2–4 years of actuarial experience are required.

Qualifications

• Bachelor’s degree in a quantitative field or actuarial science.
• 2–4 years of actuarial analytics or healthcare analytics experience.
• Experience with large datasets, modeling, and reporting.

Responsibilities

• Develop and maintain actuarial analyses, models, and reporting that support pricing, forecasting, reserving, risk adjustment, and financial planning decisions.
• Analyze claims, utilization, membership, risk scores, and provider performance to identify trends and opportunities.
• Prepare defined components of Medicare Advantage bid submissions and actuarial exhibits.
• Present findings to leadership in a clear, actionable manner.

Skills

Actuarial analysis

Forecasting

Data analysis

Stakeholder communication

Education

Bachelor’s degree in Actuarial Science or related quantitative field

Tools

SQL

Python

R

Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.This is a remote position.The Actuarial Analyst II is an experienced individual contributor who performs actuarial analyses supporting Medicare Advantage pricing, forecasting, reserving, risk adjustment, bid development, and financial performance management. The role independently manages defined analyses and workstreams, develops reliable models and reporting, and translates quantitative findings into clear recommendations for actuarial leadership and cross-functional partners. This position works closely with Finance, Product, Network, Operations, and clinical or risk-adjustment teams to identify financial risks, opportunities, and emerging trends.General Duties/Responsibilities (May include but are not limited to):Develop and maintain actuarial analyses, models, and reporting that support pricing, forecasting, reserving, risk adjustment, and financial planning decisions.Analyze claims, utilization, membership, risk scores, provider performance, and benefit experience to identify financial trends, risks, opportunities, and key drivers.Prepare defined components of Medicare Advantage bid submissions, actuarial exhibits, and supporting documentation in accordance with established methodologies and regulatory guidance.Perform monthly and quarterly reserve, accrual, and financial-performance analyses; validate results, reconcile data, and explain material variances.Evaluate the financial impact of product, benefit, network, operational, and regulatory changes, and communicate implications to business partners.Build and improve repeatable actuarial models, tools, dashboards, controls, and documentation using sound data-management, validation, and version-control practices.Present analysis, assumptions, results, and recommendations to actuarial leadership and cross-functional stakeholders in a clear, concise, and audience-appropriate manner.Provide technical guidance and quality-review support to less experienced analysts, as assigned, while continuing to develop subject-matter expertise.Participate fully in the Actuarial Development Program by pursuing actuarial examinations, completing development activities, incorporating feedback, and applying new knowledge to work assignments.Supervisory Requirements:N/AJOB Requirements:Experience:2-4 years of actuarial, healthcare analytics, insurance, financial modeling, or other relevant quantitative analysis experienceExperience working with large datasets, financial or actuarial models, and reporting tools.Demonstrated ability to independently organize and complete defined analyses, validate outputs, identify issues, and communicate findings.Experience partnering with nontechnical stakeholders to explain quantitative results and support decisions.Education/Licensure:Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Finance, Economics, or related quantitative field; or equivalent combination of education and experience.Additional Requirements:Must actively participate in the Actuarial Development ProgramSuccessfully passed 2-4 actuarial examinationsActuarial modeling, forecasting, and financial analysisHealthcare cost, utilization, membership, and risk-adjustment analyticsCross-functional collaboration and stakeholder managementPreferred:Previous knowledge of Medicare AdvantageProgramming experience in SQL, R or PythonWork Environment:· The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Essential Physical Functions:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Pay Range: $77,905.00 - $116,858.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [e-mail].