Icon Health
Complete navigation and care delivery for all Musculoskeletal (MSK) conditions
Senior Actuarial Analyst
Location
United States
Posted
95 days ago
Salary
Not specified
Bachelor Degree5 yrs expEnglishPythonSQLVBA
Job Description
• Design and execute analyses that evaluate clinical, operational, and financial performance across markets and programs.
• Build and maintain actuarial models that estimate total cost of care, risk adjustment, savings performance, and value-based contract projections.
• Support quarterly and annual reconciliation processes for shared savings and cost containment programs.
• Develop predictive models to identify high-risk populations and opportunities for intervention.
• Own key dashboards and reporting tools that track MSK performance across cost, utilization, access, and outcomes metrics.
• Partner with operations and market management teams to analyze referral volumes, patient engagement, and care pathway efficiency.
• Collaborate with the clinical team to assess patient-reported outcomes (PROs), treatment effectiveness, and adherence patterns.
• Serve as a key partner to the sales and contracting teams by providing actuarial input for payer proposals and renewals.
• Work closely with the data engineering team to ensure data integrity, accuracy, and accessibility across claims, EMR, and operational systems.
• Translate complex analyses into clear, actionable insights for leadership and external partners.
• Identify gaps or inconsistencies in existing analytics workflows and propose improvements to enhance automation, accuracy, and interpretability.
• Stay current with CMS, Medicare Advantage, and commercial payer methodologies related to risk adjustment, cost benchmarking, and value-based payments.
Job Requirements
- 5–7 years of experience in data analytics, actuarial analysis, or healthcare financial modeling.
- Prior experience with healthcare claims data, risk adjustment, or value-based care analytics strongly preferred.
- Experience supporting shared savings programs, MA performance analysis, or population health contracts a plus.
- Advanced proficiency in SQL, Python, or R for data extraction, analysis, and modeling.
- Familiarity with actuarial modeling tools (e.g., SAS, Excel VBA, Prophet) preferred.
- Strong understanding of cost and utilization measures, HCC risk adjustment, and episode-based performance.
- Ability to synthesize complex data into concise insights and compelling visualizations.
- Strong written and verbal communication skills, particularly for translating analytical findings for non-technical audiences.
- Comfort presenting to senior leadership and external partners.
- Detail-oriented and highly organized, with a focus on accuracy and reproducibility.
- Curious, proactive, and driven to improve systems and outcomes through data.
- Deeply aligned with Icon’s mission to make high-quality, value-based MSK care accessible and affordable.
Benefits
- Comprehensive benefits package including health insurance, retirement plans, and paid time off.
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