Senior Actuary, Health Plan Analytics

About the role

Reveleer is seeking a senior actuary to lead health plan and risk adjustment analytics across multiple lines of business, including Medicare Advantage, MAPD, ACA, Medicaid, and value‑based contracts. The role involves building member‑level actuarial models and translating them into dashboards that support pricing, forecasting, and strategic decisions for customers.

Key responsibilities

• Develop and maintain actuarial models for risk adjustment performance, HCC capture, utilization patterns, and population health metrics.
• Create analytics to support rate‑setting for Medicare Advantage bids, ACA filings, Medicaid capitation, and value‑based contracts.
• Reconcile RAF calculations with source files and extend logic into customer‑facing reports.
• Design dashboard logic and collaborate with data engineering and product teams.
• Produce forecasting and accrual models for settlement estimates and financial reporting.
• Analyze utilization trends and MLR drivers to identify actionable opportunities.
• Support RADV readiness by modeling audit exposure and prioritizing chart review.

Required profile

• 7+ years of actuarial or analytics experience in health plan pricing, risk adjustment, or medical economics.
• Experience with at least three of: Medicare Advantage, MAPD, ACA, Medicaid, value‑based contracts.
• Knowledge of CMS‑HCC, RAF score calculation, and ICD‑10 coding impact.
• Bachelor's degree in a quantitative field; ASA/FSA designation preferred.
• Strong communication skills for presenting to executive audiences.

Required skills

• SQL
• SAS
• R
• Python
• Tableau or Power BI
• AI tools for modeling

What we offer

• Competitive salary
• Medical, dental, and vision benefits
• 401k match
• Generous PTO plan