Senior Actuarial Analyst

Acturhire; Boston (MA); Hybrid; USD 130,000 - 140,000; Full time

Benefits offered by this job

Medical, dental, vision, life, and EDI

401K with company match

Flexible PTO and holidays

Parental leave (up to 14 weeks)

Pet insurance

Job summary

Cohere Health is seeking a Senior Actuarial Analyst to own models and core reporting quantifying customer outcomes, impact, and cost savings for prior authorization programs. You will partner with clinical, customer success, and data teams to ensure accurate, consistent results and compelling storytelling for leadership and external customers.

This remote-first role may require travel to Boston, MA for onboarding and in-person team meetings and events.

Qualifications

• 5+ years in actuarial or healthcare analytics with relevant degree and exams.
• Demonstrated experience delivering client-facing reports and models measuring impact and savings.
• Proficiency with SQL, Excel, and visualization tools; knowledge of Python, R, or SAS.

Responsibilities

• Own client-facing reporting measuring cost savings, outcomes, and performance of prior authorization programs.
• Build, maintain, and QC actuarial models and methodologies behind reporting.
• Analyze authorization and claims data to identify trends and quantify impact.
• Design and run impact evaluations including baseline, cohorts, and comparisons.
• Reconcile authorization-based impact with realized claims and explain changes.
• Prepare executive-level insights and present results to customers and leadership.
• Collaborate with customer success, clinical, and actuarial teams to align metrics and narratives.
• Maintain documentation for reproducibility and audits.

Skills

Analytical skills

Communication

Presentation of results

Healthcare analytics knowledge

Team collaboration

Education

Bachelor's degree in Actuarial Science/Math/Statistics/Biostatistics/Economics

2 SOA exams completed (ASA preferred)

Tools

SQL

Excel

Tableau

Python/R/SAS

Job description

Opportunity Overview:

We are seeking a Senior Actuarial Analyst to join our Actuarial team. In this role, you will own the models and core reporting that quantify customer outcomes, impact, and cost savings for Cohere’s prior authorization programs, and present what is driving those results to internal leadership and external customers. You’ll partner closely with clinical, customer success, and data teams to keep the numbers accurate and consistent, making this an opportunity to shape how Cohere measures and communicates the value it delivers.

This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.

What you’ll do:

• Own and maintain client-facing reporting that measures cost savings, outcomes, and performance of prior authorization programs across specialty areas (MSK, cardiology, diagnostic imaging, therapy, sleep, and others).
• Build, maintain, and QC the actuarial models and methodology behind that reporting, and keep them ready to scale to new clients and lines of business.
• Analyze and interpret authorization and claims data to identify trends, key drivers, and opportunities to improve customer value, and quantify the dollar and utilization effect of each.
• Design and run impact evaluations and post-implementation assessments: define intervention and comparison cohorts, baselines and benchmarks, units of measurement, and methods (pre and post, difference-in-differences, quasi-experimental), including sensitivity analyses that isolate true Cohere impact and validate savings.
• Reconcile authorization-based impact against realized claims, and investigate and explain month-over-month and quarter-over-quarter changes.
• Prepare and present clear, executive-level insights and results to external customers and internal leadership, articulating assumptions, drivers, and implications.
• Partner closely with customer success, clinical, and actuarial teams to align metrics, assumptions, and narratives, and build client trust in the numbers.
• Maintain documentation of methodology, mappings, and code so the work is reproducible, auditable, and easy to hand off, and continuously refine reporting and storytelling for clarity and client relevance.

What you’ll need:

• 5+ years of experience in actuarial or healthcare analytics (payer, provider, managed care, or consulting), with a Bachelor’s degree in Actuarial Science, Math, Statistics, Biostatistics, or Economics and at least 2 completed SOA exams. ASA preferred.
• Demonstrated expertise developing, maintaining, and delivering client-facing reports and the models behind them that measure impact, savings, and performance.
• Proficiency with SQL, Excel, and a visualization tool such as Tableau, plus a statistical or analytics language such as Python, R, or SAS.
• Strong analytical and communication skills, including a working command of healthcare cost drivers and medical claims or authorization data, enough to translate complex analyses into clear, concise insight for external customers and internal stakeholders.
• Ability to present results to external customers and internal leadership, field questions in the moment, and articulate assumptions, drivers, and implications.

Bonus:

• Experience in prior authorization or utilization management, including the workflows, data, and performance metrics behind them.
• Familiarity with healthcare analytics tooling such as Python or R and cloud environments (for example AWS S3, Athena, Spark, Airflow).
• Advanced degree in a quantitative field, or an ASA credential.
• Demonstrated success presenting savings and impact results directly to external clients.

Pay & Perks:

Fully remote opportunity with about 5% travel

Medical, dental, vision, life, disability insurance, and Employee Assistance Program

401K retirement plan with company match; flexible spending and health savings account

Flex Time Off + company holidays

Up to 14 weeks of paid parental leave

Pet insurance

The salary range for this position is $130,000 to $140,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Interview Process*:

1. Connect with Talent Acquisition for a Preliminary Phone Screening
2. Meet your Hiring Manager!
3. Team Interview
4. Cross-Functional
5. Executive Interview

*Subject to change*

About Cohere Health:

Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.

With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.

The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

We can’t wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement:

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.

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