Senior Actuarial Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $130k - $140k / year

⏰ Full Time

🟠 Senior

📊 Actuary

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Cohere Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cohere Health is a company focused on transforming the prior authorization process in healthcare using advanced technologies. The company offers the Cohere Unify™ Platform, which includes artificial intelligence and machine learning capabilities to improve utilization management (UM) and facilitate quicker access to patient care. By digitizing the prior authorization process and integrating with electronic medical records, Cohere Health aims to enhance the quality of healthcare outcomes and reduce the administrative burden on providers. Their solutions help decrease denial rates and adverse outcomes through evidence-based intelligence and real-time clinical suggestions. Cohere Health's offerings are available as Platform as a Service (PaaS) or as fully outsourced solutions.

📋 Description

• Own and maintain client-facing reporting measuring cost savings, outcomes, and performance of prior authorization programs across specialty areas • Build, maintain, and QC actuarial models and methodology behind reporting, keeping them scalable to new clients and lines of business • Analyze and interpret authorization and claims data to identify trends, key drivers, and opportunities to improve customer value • Design and run impact evaluations and post-implementation assessments using cohorts, baselines, benchmarks, pre/post analysis, difference-in-differences, and quasi-experimental methods • Conduct sensitivity analyses to isolate Cohere’s impact and validate savings • Reconcile authorization-based impact against realized claims and investigate month-over-month and quarter-over-quarter changes • Prepare and present executive-level insights and results to external customers and internal leadership • Partner with customer success, clinical, and actuarial teams to align metrics, assumptions, and narratives • Maintain documentation of methodology, mappings, and code so work is reproducible, auditable, and easy to hand off • Continuously refine reporting and storytelling for clarity and client relevance

🎯 Requirements

• 5+ years of experience in actuarial or healthcare analytics (payer, provider, managed care, or consulting) • Bachelor’s degree in Actuarial Science, Math, Statistics, Biostatistics, or Economics • At least 2 completed SOA exams • ASA preferred • Expertise developing, maintaining, and delivering client-facing reports and models measuring impact, savings, and performance • Proficiency with SQL, Excel, and a visualization tool such as Tableau • Proficiency with a statistical or analytics language such as Python, R, or SAS • Working command of healthcare cost drivers and medical claims or authorization data • Ability to translate complex analyses into clear, concise insights • Ability to present results to external customers and internal leadership, field questions, and articulate assumptions, drivers, and implications • Bonus: Experience in prior authorization or utilization management • Bonus: Familiarity with Python or R and cloud environments such as AWS S3, Athena, Spark, or Airflow • Bonus: Advanced degree in a quantitative field or ASA credential • Bonus: Demonstrated success presenting savings and impact results directly to external clients

🏖️ Benefits

• Fully remote opportunity with about 5% travel • Medical, dental, vision, life, disability insurance, and Employee Assistance Program • 401K retirement plan with company match • Flexible spending and health savings account • Flex Time Off + company holidays • Up to 14 weeks of paid parental leave • Pet insurance • Bonus included as part of the total benefits package

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