Director, Actuarial Analytics – Healthcare Utilization & Revenue Forecasting

Job not on LinkedIn

October 22

🍂 Massachusetts – Remote

Although this job is listed in Massachusetts, this company may be open to hiring remote in other states.

🤠 Texas – Remote

Although this job is listed in Texas, this company may be open to hiring remote in other states.

+1 more states

🍂 Massachusetts – Remote 🤠 Texas – Remote 🍁 Vermont – Remote

⏰ Full Time

🔴 Lead

📊 Actuary

🦅 H1B Visa Sponsor

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athenahealth

WebsiteLinkedInAll Job Openings

Healthcare Insurance • SaaS • Artificial Intelligence

athenahealth is a provider of healthcare software solutions focused on enhancing clinical effectiveness, patient experience, and financial performance. Its flagship product, athenaOne, is an all-in-one solution that includes electronic health records (EHR), revenue cycle management (RCM), and patient engagement tools. The company offers tailor-made solutions for various healthcare providers, ranging from small practices to large health systems and specialities like behavioral health and pediatrics. athenahealth also provides payer solutions, advisory services, and platform services to improve patient outcomes and reduce costs, while ensuring a highly reliable service with 99. 98% uptime. Their solutions also incorporate AI-powered features like Ambient Notes to streamline clinical documentation. With a focus on interoperability and efficiency, athenahealth aims to simplify healthcare delivery and improve outcomes for both providers and patients.

5001 - 10000 employees

Founded 1997

⚕️ Healthcare Insurance

☁️ SaaS

🤖 Artificial Intelligence

💰 Post-IPO Equity on 2017-05

📋 Description

• Develop and lead actuarial forecasting models for utilization, revenue, and cost across products and lines of business • Manage pricing analyses and rate-setting workstreams for government (Medicare, Medicaid) contracts and commercial payer models • Analyze utilization trends and identify drivers to inform financial projections and strategic recommendations • Build and maintain financial models and dashboards to support monthly/quarterly forecasting and executive reporting • Collaborate with sales, product, and operations to evaluate contract economics, renewals, and new business opportunities • Mentor and review work from actuarial and analytics staff, ensuring methodological rigor and quality control • Present findings and recommendations to senior finance and business leaders to support strategic decision-making • Support development of actuarial documentation and knowledge sharing across the finance organization • Support ad hoc actuarial analyses for M&A, strategic investments, or special projects as requested • Contribute to process improvements in forecasting, pricing, and reporting workflows • Partner with regulatory and compliance teams on modeling assumptions related to reimbursement and policy changes • Prepare documentation and assumptions for audit and external reporting needs • Participate in vendor and third-party model evaluations and oversight

🎯 Requirements

• Bachelor’s degree in Actuarial Science, Statistics, Mathematics, or related field (Master’s preferred) • Associate or Fellow of the Society of Actuaries (ASA or FSA) • 8+ years of experience in healthcare actuarial roles, with deep expertise in forecasting, pricing, and utilization analysis • Experience with government healthcare contracts (Medicare, Medicaid) and commercial payer models • Advanced proficiency in Excel, SQL, SAS, and other analytical tools; experience with data visualization platforms (e.g., Power BI, Tableau) preferred • Strong communication skills, with the ability to present complex analyses to non-technical audiences • Demonstrated leadership in managing projects and mentoring teams • Creative problem-solving skills and intellectual curiosity; ability to thrive in a fast-paced, evolving environment • Experience with value-based contracting and risk adjustment analytics • Prior consulting experience or exposure to multiple payer environments preferred • Proven ability to integrate actuarial standards with business strategy and operational goals preferred

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible working arrangements • Professional development • Employee assistance programs • Tuition assistance • Commuter support • Collaborative workspaces