Note: The job is a remote job and is open to candidates in USA. Cohere Health provides clinical intelligence and AI-powered solutions that connect health plans and providers to improve the speed, cost, and quality of care. The Senior Actuarial Support Analyst will develop and maintain financial models, evaluate healthcare cost-saving initiatives, analyze prior authorization and claims data, and provide strategic insights and recommendations to leadership and stakeholders.
Responsibilities
- Design and maintain complex financial models to track and analyze cost-saving initiatives, providing regular updates and insights to senior leadership and stakeholders
- Perform advanced data analysis to assess prior authorization & claims trends, decision patterns, and cost drivers
- Lead the design and development of financial models to 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 that may indicate areas for improvement on savings
- Prepare detailed and executive-level reports and presentations that summarize cost-saving achievements, project performance, and future cost-saving potential
- Act as a trusted advisor to leadership and key internal & external stakeholders, providing strategic insights, recommendations, and guidance on cost-saving strategies
- Work closely with clinical and customer success teams to understand authorization challenges, provide analytical insights, and offer actionable recommendations to resolve issues
- Lead post-implementation assessments to measure the impact of cost-saving initiatives, ensuring continuous refinement and long-term sustainability of improvements
Skills
- 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, for example SQL, Tableau, Power BI, advanced Excel
- Strong understanding of healthcare cost drivers and medical claims data
- Demonstrated experience in data cleaning, data analysis and problem-solving skills
- Ability to transform complex data into actionable insights and clear, concise reports
- Familiarity with prior authorization, utilization management processes
- Proficient in R, SQL, Python, Scala, AWS (S3, Airflow, Athena, Spark)
- Experience with prior authorization & 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
Company Overview