Senior Actuarial Analyst

Role Overview

The team is looking for a health actuary to support financial performance across Medicare Advantage, with a focus on revenue analytics, risk adjustment, forecasting, claims performance and operational reporting. This person will work closely with actuarial, finance, analytics, accounting, operations and leadership teams to improve visibility across revenue, medical cost and business performance.

Key Responsibilities

Medicare Advantage Revenue and Risk Adjustment

• Build, refresh and enhance analytical tools used to project Medicare Advantage revenue across multiple contracts.

• Review risk score development, RAF movement, coding patterns and revenue performance to identify material trends and areas of opportunity.

• Support recurring financial cycles including budgeting, reforecasting, accruals, performance reporting and explanation of key variances.

• Assess how CMS methodology changes, HCC model updates and regulatory developments may affect revenue assumptions.

• Complete revenue-focused analysis linked to membership mix, clinical programmes, operational changes and wider business initiatives.

Reserving, Close and Financial Reporting

• Support monthly claims liability and IBNR-related analysis.

• Contribute to the monthly close process through reporting, analysis and review of actuarial inputs.

• Help prepare recurring management reporting and commentary on emerging financial results.

Forecasting, Modelling and Business Planning

• Develop models to project future revenue, claims cost, utilisation and financial performance.

• Evaluate the expected impact of operational, clinical or strategic initiatives.

• Partner with functional leaders to understand assumptions, pressure-test business drivers and align modelling outputs with organisational priorities.

• Produce variance analysis, financial summaries and ad hoc modelling for leadership review.

Healthcare Data and Reconciliation

• Analyse claims, utilisation, cost, membership and payer data to identify trends, anomalies and performance drivers.

• Support reconciliations between internal reporting, external payer files and detailed source data.

• Act as a point of contact for payer data questions, file issues, reporting gaps and supplemental information requests.

Performance Monitoring and Operational Insight

• Track financial and operational KPIs to identify risks, improvement opportunities and emerging issues.

• Work with operational teams to translate analysis into practical recommendations.

• Evaluate the financial value and cost-effectiveness of healthcare programmes, interventions and business initiatives.

• Support the development of dashboards, reporting packs and executive-level performance views.

Cross-Functional Partnership

• Collaborate with IT, finance, accounting, actuarial, analytics and operations teams to improve reporting processes, data quality and financial visibility.

• Help streamline recurring workflows and improve the accuracy, consistency and usability of actuarial and financial reporting.

Required Experience and Skills

• Medicare Advantage actuarial experience.

• Working knowledge of CMS risk adjustment, RAF calculations and HCC models, including v24 and v28.

• Experience with actuarial modelling, forecasting, financial analysis or variance reporting.

• Strong Excel capability.

• SQL experience, ideally 2+ years.

• Ability to work with large healthcare datasets and connect detailed data to financial results.

• Understanding of P&L performance and the drivers behind revenue, claims cost and margin movement.

• Strong analytical judgement, problem-solving ability and attention to detail.

• Comfortable managing multiple workstreams in a fast-moving environment.

• Able to work effectively with stakeholders across actuarial, finance, operations, IT and senior leadership.

• Open to limited travel, expected to be no more than 10-15%.

Qualifications

• Bachelor’s degree in actuarial science, mathematics, statistics, economics, finance or a related discipline.

• Advanced degree or MBA is beneficial but not required.

• 2-5 years of relevant healthcare actuarial experience preferred.

• 3+ actuarial exams, with candidates likely to be at Pre-ASA or ASA level.