Senior Actuarial Analyst — Remote Health Analytics

Wellsense-Health-Plan; United States; Remote; USD 89,000 - 129,000; Full time

Benefits offered by this job

Full-time remote work

Competitive salaries

Excellent benefits

Job summary

WellSense Health Plan is seeking a Senior Actuarial Analyst to join our Finance/Actuarial Services team. The role blends actuarial analysis, data modeling, and financial forecasting to support pricing, reserving and healthcare analytics.

With a focus on collaboration, you will lead or support rate filings, IBNR reserves, budgets, and provider analytics while leveraging SQL/SAS to extract and validate data. This remote, full-time opportunity offers competitive pay and robust benefits.

Qualifications

• Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields.
• At least 4 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis.
• Commensurate educational experience in related field will be considered.

Responsibilities

• Analyzes financial, statistical and mathematical data and performs actuarial calculations.
• Leads or supports the rate development through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost.
• Leads or supports regulatory rate filings, and prepares data for additional inquiries and requirements.
• Leads or supports the development of monthly IBNR reserve estimates for different line of business.
• Prepares monthly accruals and contract settlements for different line of business.
• Leads or supports financial budget, reforecast and other financial projections.
• Evaluates and makes recommendations regarding the adequacy of capitation rates from state Medicaid programs or other new program.
• Leads or assists in risk adjustment analyses and risk score simulations.
• Leads or supports trend development, trend drivers study, and/or provider contract analytics.
• Maintains established reports for internal needs or regulatory requirements.
• Participates in internal and external audits.
• Generates ideas and analytical approaches for corporate initiatives/projects.
• Designs or updates SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity.
• Serves as data expert for department.
• Advises Finance department on data warehouse design, requests and works with IT to establish priorities.
• Initiates and leads efforts to improve quality and efficiency of actuarial models, analyses and reports.
• Summarizes findings and recommendations, documents the process.
• Develops presentations and communicates to senior management or external parties.
• Shares knowledge and provides training to new employees.

Skills

MS Office

Excel

Healthcare data

Strong communication skills

Education

Bachelor’s degree in Mathematics/Actuarial Science/Finance/Economics or related fields

Master’s degree

Tools

SQL

SAS

Job description

WellSense Health Plan is seeking a Senior Actuarial Analyst to join our Finance/Actuarial Services team. The role blends actuarial analysis, data modeling, and financial forecasting to support pricing, reserving and healthcare analytics.

With a focus on collaboration, you will lead or support rate filings, IBNR reserves, budgets, and provider analytics while leveraging SQL/SAS to extract and validate data. This remote, full-time opportunity offers competitive pay and robust benefits.