Senior Actuarial Support Analyst

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $105k - $115k / year

⏰ Full Time

🟠 Senior

📞 Support Engineer

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This company has sponsored H1B visas in the past.

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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

• Evaluate cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process • Develop and maintain cost savings models • Design and maintain complex financial models tracking and analyzing cost-saving initiatives • Provide regular updates and insights to senior leadership and stakeholders • Perform advanced data analysis of prior authorization and claims trends, decision patterns, and cost drivers • Quantify the impact of proposed cost-saving initiatives and forecast cost reduction outcomes for business cases • Use statistical and data visualization tools to identify trends, patterns, and anomalies in claims data • Prepare executive-level reports and presentations on cost-saving achievements, project performance, and future cost-saving potential • Advise leadership and internal and external stakeholders on cost-saving strategies • Collaborate with clinical and customer success teams to understand authorization challenges and provide actionable recommendations • Lead post-implementation assessments to measure initiative impact and support continuous improvement

🎯 Requirements

• 5 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting • Proficiency in data analytics and visualization tools, including SQL, Tableau, Power BI, and advanced Excel • Strong understanding of healthcare cost drivers and medical claims data • Demonstrated experience in data cleaning, data analysis, and problem-solving • Ability to transform complex data into actionable insights and clear, concise reports • Familiarity with prior authorization and utilization management processes • Proficiency in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark) • Experience with prior authorization and utilization management data

🏖️ 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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