Own actuarial contract modeling for Medicare Advantage, Medicaid, and Commercial payer agreements. Build financial models, dashboards, and reporting infrastructure; analyze contract performance and financial impacts; support payer negotiations; monitor reimbursement, legislation, market, and risk-adjustment trends; and provide cross-functional insights across finance, analytics, contracting, and operations.
We are seeking an Actuarial Senior Analyst to help drive the financial analytics behind our payer contracts. This role will own contract modeling across our MA, Medicaid, and Commercial business. You'll build models from scratch, track contract performance, and support payer negotiations. This role will report to the Senior Manager, Actuary and is open for remote work.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Strategic Deal Modeling: Craft sophisticated deal models to support contract negotiations with health plans, ensuring favorable terms and optimal outcomes.
- Data-Driven Insights: Utilize data and analytics to provide consultative support, driving financial and operational performance improvements for our health plan contracts.
- Financial Impact Analysis: Employ advanced data tools to track, analyze, forecast, and report on the financial impact of payer contracts.
- Infrastructure Development: Build robust analytical infrastructure, including comprehensive reports and dashboards, to monitor payer financial performance.
- Market Trend Monitoring: Stay ahead of industry developments researching topics such as changes in legislation, market share, Star Ratings, bid strategies, and reimbursement trends.
- Ad Hoc Analysis: Conduct a variety of analyses related to benchmarking, contract optimization, investor relations, risk adjustment, and more.
- Cross-Functional Collaboration: Work closely with teams across Reserving, Analytics, Data, Finance, M&A, Contracting, Medical Economics, and Operations.
Qualifications
- FSA or ASA credentials or near attainment of ASA credentials.
- 3+ years of experience in actuarial roles.
- 1+ years of experience in VBC or VBC adjacent roles.
- Advanced knowledge of Microsoft Excel.
- Intermediate knowledge of SQL.
- Champion of independent critical thinking, unafraid to challenge the status quo and explore innovative solutions.
- Proficiency and desire to build actuarial models from scratch.
- Comfortable working on a small team in a fast-paced environment.
Preferred Qualifications:
- Knowledge in health plan reimbursement methodologies.
- Experience working on the provider side of healthcare.
- Experience in Medicare Advantage bid mechanics.
- Risk adjustment experience.
- Experience in the California healthcare market.
- Understanding of the actuarial continuum (both pricing/forecasting and valuation/reserving).
Environmental Job Requirements and Working Conditions
- This position has the option to be remotely based in the U.S. Conversely, candidates can choose to work in a hybrid fashion and work through the Alhambra, CA, Las Vegas, NV, or Houston, TX Astrana Health offices.
- The hiring manager for this role sits in the Eastern Time Zone, while many of the business partners work on Pacific Time.
- The total compensation target pay range for this role is: $100,000 – $135,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
- Astrana Health offers a competitive Actuarial Student Program for any candidate seeking their ASA or FSA credentials.
About
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Astrana Health, Inc. Alhambra, California, USA Office
Alhambra, CA, United States
Similar Jobs
Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Leads enterprise data and analytics strategy, architecture, modernization, and delivery across cloud and on-premises environments. Oversees data platforms, engineering, integration, governance, quality, lineage, security, and compliance. Partners with executives to define roadmaps and investments, manages cross-functional teams and vendors, enables AI/ML capabilities, and mentors data professionals while driving scalable, trusted data solutions and measurable business outcomes.
Top Skills:
AgileSparkAzure Data PlatformCloud ComputingData GovernanceData LakesData LineageData WarehousingDatabricksMaster Data ManagementMetadata ManagementAzurePythonSQL
Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Develops and maintains Access databases, SQL reports, Cognos and Power BI dashboards, SharePoint solutions, and operational workflows. Analyzes transactional, financial, staffing, productivity, and performance metrics; validates data; creates projections and regulatory reports; and presents findings to senior leadership. Partners with stakeholders and IT to gather requirements, improve processes, automate workflows, ensure data integrity, and support compliance and business operations.
Top Skills:
AlteryxCognosETLInfopathMicrosoft AccessPower BIPowerPointRSASSharepointSpssSQLSQL ServerSsisVBA
Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Reviews medical insurance applications for group life and disability coverage, researches medical conditions and medications, orders additional medical documentation, and applies underwriting guidelines to approve, deny, or pend cases. Maintains quality and consistency across cases while communicating clearly, using multiple systems, incorporating feedback, and applying clinical expertise to business underwriting decisions.
Top Skills:
Ai ToolsExcelMS OfficeMicrosoft Word
What you need to know about the Los Angeles Tech Scene
Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.
Key Facts About Los Angeles Tech
- Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
- Key Industries: Artificial intelligence, adtech, media, software, game development
- Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
- Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering
