Actuarial Analyst, Medical Economics

📋 Description

• • Own the end-to-end development of Accompany Health’s medical trend and ROI reporting engine. You will design, build, and maintain actuarial models that quantify the financial impact of our integrated primary, behavioral, and social care model on low-income, complex-needs populations.
• • Translate raw claims, clinical, and operational data into clear, decision-ready insights for the Chief Actuary, CFO, and cross-functional leaders. Your analyses will directly influence payer negotiations, program expansion, and value-based contract design.
• • Partner daily with Reserving, FP&A, Data Science, Analytics, and Operations to ensure that every clinical initiative has a measurable ROI target and a rigorous post-implementation evaluation plan.
• • Create and refresh monthly dashboards that track medical cost trend drivers (inpatient, outpatient, pharmacy, behavioral health, social determinants spend) and flag emerging risks or savings opportunities at the member, provider, and market levels.
• • Build scenario-based forecasting models that simulate the financial impact of prospective interventions—e.g., 24/7 home-based care teams, expanded behavioral health coverage, or new community partnerships—so leadership can prioritize investments with the greatest potential to bend the cost curve.
• • Lead deep-dive studies that isolate the incremental value created by Accompany Health’s care model versus matched control groups; publish findings that strengthen our value story with Medicare Advantage, Medicaid MCO, and commercial payer partners.
• • Support actuarial reserving and IBNR calculations by providing credible trend assumptions derived from your medical economics analyses, ensuring that financial statements reflect the unique risk profile of our population.
• • Develop and maintain comprehensive documentation of methodologies, assumptions, and data lineage to satisfy both internal governance and external audit requirements.
• • Present complex actuarial concepts to non-technical audiences—clinicians, operators, community leaders—using plain language and compelling visuals that drive action.
• • Contribute to the design of new value-based payment arrangements by modeling shared-savings, capitation, and hybrid structures that align incentives between Accompany Health and its payer partners.
• • Continuously refine data pipelines and analytical tooling; identify opportunities to automate repetitive tasks and scale insights across markets as Accompany Health grows nationally.
• • Stay current on regulatory changes affecting Medicare Advantage, Medicaid, and dual-eligible populations; proactively assess the actuarial implications and recommend strategic responses.
• • Mentor junior analysts and interns, fostering a culture of rigorous quantitative thinking and mission-driven curiosity.
• • Champion health-equity analytics—quantify disparities in cost, access, and outcomes across racial, ethnic, and geographic lines, and partner with clinical teams to design interventions that close gaps.
• • Work in a fully remote environment with teammates spread across time zones; demonstrate exceptional asynchronous communication skills and a bias toward transparency.