Actuarial Analyst
Job description
About the role
The is positioned at the intersection of data science and healthcare finance, where you will apply rigorous analytical techniques to real-world business problems. This role owns the execution of quantitative analyses that directly influence strategic decisions affecting Medicare Advantage operations and member outcomes. You will be responsible for developing and maintaining sophisticated analytical models that translate complex healthcare data into actionable financial insights. The position requires a proactive approach to cross-functional collaboration, ensuring that actuarial findings support measurable improvements in pricing, reserving, and risk adjustment. You will own the communication of intricate analytical concepts to non-technical stakeholders through clear and compelling data storytelling. This role provides ownership over the full lifecycle of actuarial projects, from initial problem definition through to implementation and validation. The position is designed for a self-motivated individual who takes ownership of their learning curve and professional development within a fast-paced environment. Ultimately, this role owns the critical function of bridging advanced analytics with practical business strategy to enhance the financial health of the organization.
Key facts
What you'll do
Analyze financial forecasting, medical cost analysis, revenue optimization, reserving, pricing, risk adjustment, and value-based care initiatives to support strategic decision-making.
Develop and maintain analytical models using actuarial principles, statistical methods, and large healthcare datasets to evaluate performance and identify trends.
Partner with actuaries and cross-functional business leaders to analyze operational and financial performance, investigate emerging trends, and develop data-driven recommendations.
Prepare reports, dashboards, and executive presentations that communicate complex analytical findings and support business planning, forecasting, and performance monitoring.
Support enterprise financial planning by analyzing medical costs, revenue drivers, risk adjustment performance, utilization trends, and other key business metrics across the Medicare Advantage business.
Identify opportunities to improve processes and automate analyses using SQL, Excel, Python, and other AI analytical tools to increase efficiency and accuracy.
Participate in rotational assignments across multiple actuarial disciplines to develop broad business knowledge and technical expertise while contributing to strategic initiatives.
Support special projects and innovation initiatives that improve healthcare affordability, operational performance, member outcomes, and enterprise financial results.
Perform in-depth data quality checks and validation procedures to ensure the integrity and reliability of analytical outputs.
Conduct ad-hoc analyses to address specific business questions and support timely decision-making for leadership.
Collaborate with data engineering and IT teams to streamline data pipelines and improve the accessibility of analytical datasets.
Translate business requirements into technical specifications to guide the development of analytical solutions and reporting tools.
Monitor industry trends and regulatory changes to assess potential impacts on actuarial assumptions and financial models.
Contribute to the continuous improvement of actuarial methodologies and best practices within the Clover Health organization.
Requirements
Demonstrate a strong quantitative background with a solid foundation in statistical analysis and financial modeling techniques.
Possess a Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field.
Have eligibility to take at least two actuarial exams upon joining, showing a commitment to professional credentialing.
Maintain progress toward Associate or Fellow actuarial credentialing throughout your tenure in this role.
Show proficiency in statistical programming and data manipulation languages, with a demonstrated ability to work effectively in a technical environment.
Exhibit advanced skills in Microsoft Excel, including complex formulas, data manipulation, and visualization techniques.
Bring experience with SQL querying and database management to efficiently extract and transform data.
Display strong written and verbal communication skills, enabling the explanation of complex analytical results to diverse audiences.
Possess a proven ability to manage multiple priorities in a fast-paced, deadline-driven environment while maintaining attention to detail.
Nice to have
Experience with Python and data visualization tools such as Tableau or Power BI is preferred.
Familiarity with Medicare Advantage products, risk adjustment models (HCC), and value-based care arrangements is a distinct advantage.
Prior experience in a healthcare, insurance, or consulting environment is considered beneficial.
Knowledge of actuarial modeling for population risk and cost analysis is a preferred qualification.
Experience with automation tools such as Alteryx or Tableau Prep is valued.
Practical notes
This is a full-time position based in the United States with remote work arrangements.
New start dates are contingent upon business needs and visa sponsorship requirements where applicable.
Candidates must be eligible to work in the United States without sponsorship requirements for this role.