Senior Actuarial Analyst - Remote Healthcare Analytics

Alignment Health; Orange (CA); Remote; USD 86,000 - 129,000; Full time

Job summary

Alignment Health is seeking a Senior Actuarial Analyst to drive advanced actuarial analyses, financial modeling, and data-driven insights across reserves, risk adjustment, Part D, and pharmacy analytics. The role partners with finance, clinical, operations, and external stakeholders to deliver transparent insights.

This remote position emphasizes forecasting, KPI analysis, and collaboration to support budgeting and strategic decision-making within a regulated healthcare environment.

Qualifications

• 3-5 years minimum of required work experience.
• Requires a college degree with at least a minor in actuarial science, mathematics, statistics, economics, or equivalent business experience.
• Previous knowledge of Medicare Advantage is preferred.
• ASA designation or has completed the majority of the courses to complete the ASA designation.
• Programming experience in SQL, R or Python is a plus.
• Curious mindset and eagerness to learn within the actuarial field and also outside the traditional actuarial field.

Responsibilities

• Develop, maintain, and audit actuarial models and traditional actuarial methods to support monthly reserve balances, RAF accruals, Part D pass-through accruals, forecasting, trend analysis, and financial projections.
• Analyze healthcare cost and utilization trends, including pharmacy, medical cost drivers, claim adjudication, and utilization management KPIs.
• Support pricing, reserving, and financial planning activities, including budget and forecast cycles; recommend changes to methodologies based on changing circumstances and operational deviations.
• Collaborate with the HealthPlan Economics and Medicare Risk Adjustment teams, as well as cross-functional partners, to review financial performance across markets and translate complex analytics into clear business insights.
• Conduct data-driven analyses to support strategic decision-making, evaluate program performance, and assess risks and opportunities.
• Communicate the purpose and function of actuarial methods and analyses clearly to stakeholders outside the department, including leadership audiences through reports, dashboards, and presentations.
• Ensure data integrity, validation, and reconciliation across multiple data sources to support regulatory and financial reporting requirements.
• Other duties as assigned.

Skills

SQL

Python

R

Education

Actuarial science minor

Job description

Alignment Health is seeking a Senior Actuarial Analyst to drive advanced actuarial analyses, financial modeling, and data-driven insights across reserves, risk adjustment, Part D, and pharmacy analytics. The role partners with finance, clinical, operations, and external stakeholders to deliver transparent insights.

This remote position emphasizes forecasting, KPI analysis, and collaboration to support budgeting and strategic decision-making within a regulated healthcare environment.