Note: The job is a remote job and is open to candidates in USA. Cohere Health is a healthcare technology company focused on improving payer-provider decision-making and care outcomes. The Senior Actuarial Analyst will own actuarial models and client-facing reporting for prior authorization programs, analyze claims and authorization data, evaluate program impact and savings, and present insights to customers and leadership.
Responsibilities
- Own and maintain client-facing reporting that measures cost savings, outcomes, and performance of prior authorization programs across specialty areas (MSK, cardiology, diagnostic imaging, therapy, sleep, and others)
- Build, maintain, and QC the actuarial models and methodology behind that reporting, and keep them ready to scale 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, and quantify the dollar and utilization effect of each
- Design and run impact evaluations and post-implementation assessments: define intervention and comparison cohorts, baselines and benchmarks, units of measurement, and methods (pre and post, difference-in-differences, quasi-experimental), including sensitivity analyses that isolate true Cohere impact and validate savings
- Reconcile authorization-based impact against realized claims, and investigate and explain month-over-month and quarter-over-quarter changes
- Prepare and present clear, executive-level insights and results to external customers and internal leadership, articulating assumptions, drivers, and implications
- Partner closely with customer success, clinical, and actuarial teams to align metrics, assumptions, and narratives, and build client trust in the numbers
- Maintain documentation of methodology, mappings, and code so the work is reproducible, auditable, and easy to hand off, and continuously refine reporting and storytelling for clarity and client relevance
Skills
- This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events
- 5+ years of experience in actuarial or healthcare analytics (payer, provider, managed care, or consulting), with a Bachelor's degree in Actuarial Science, Math, Statistics, Biostatistics, or Economics and at least 2 completed SOA exams
- Demonstrated expertise developing, maintaining, and delivering client-facing reports and the models behind them that measure impact, savings, and performance
- Proficiency with SQL, Excel, and a visualization tool such as Tableau, plus a statistical or analytics language such as Python, R, or SAS
- Strong analytical and communication skills, including a working command of healthcare cost drivers and medical claims or authorization data, enough to translate complex analyses into clear, concise insight for external customers and internal stakeholders
- Ability to present results to external customers and internal leadership, field questions in the moment, and articulate assumptions, drivers, and implications
- ASA preferred
- Experience in prior authorization or utilization management, including the workflows, data, and performance metrics behind them
- Familiarity with healthcare analytics tooling such as Python or R and cloud environments (for example AWS S3, Athena, Spark, Airflow)
- Advanced degree in a quantitative field, or an ASA credential
- 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
Company Overview