Actuary - Medicare Stars & Quality Analytics Lead

Highmark Health; Boise (ID); On-site; USD 103,000 - 165,000; Full time

Job summary

Highmark Inc. is seeking an ASA-certified actuary to lead development of advanced actuarial models and analyses focused on forecasting Medicare Advantage Star Ratings. The role involves applying statistical techniques to healthcare data, mentoring staff, and presenting findings to stakeholders.

The candidate will monitor Star Ratings methodologies, guide cross-disciplinary teams, and contribute to clinical quality improvement using claims, enrollment, HEDIS, and CMS data.

Qualifications

• Bachelor's Degree in Actuarial Science, Mathematics, Statistics or closely related field.

Responsibilities

• Define & diagnose a problem. Outline data requirements for a study or analysis and devise insightful solutions.
• Initiate and lead the development of studies, analyses, and materials for decision makers and management across teams.
• Proactively ensure the internal and external consistency of all work and perform reasonability checks.

Skills

Actuarial knowledge

Analytical skills

Oral & written communication

Problem solving

Mentoring/leadership

Education

Bachelor's Degree in Actuarial Science/Mathematics/Statistics

Job description

Highmark Inc. is seeking an ASA-certified actuary to lead development of advanced actuarial models and analyses focused on forecasting Medicare Advantage Star Ratings. The role involves applying statistical techniques to healthcare data, mentoring staff, and presenting findings to stakeholders.

The candidate will monitor Star Ratings methodologies, guide cross-disciplinary teams, and contribute to clinical quality improvement using claims, enrollment, HEDIS, and CMS data.