Senior Actuarial Analyst at Q Point Health LLC

United States

Position Title: Senior Actuarial Analyst Reports To: Senior Director/VP - Actuarial Classification: Exempt Places of Work: Remote About the Organization:  Equality Health [https://www.equalityhealth.com/] is an integrated, holistic, and tech-enabled healthcare delivery system focused on improving the health and wellness of diverse populations. Founded in 2015, Equality Health aims to improve access to value-based care for people who have long struggled with navigating the traditional one-size-fits-all U.S. healthcare system. The mission of the company is to provide high-quality care that improves and enhances lives regardless of race, ethnicity, age, or income. Through its supplemental care management services and proprietary technology platform, CareEmpower™, Equality Health helps managed care plans and health systems improve outcomes and lower costs for diverse populations while simultaneously facilitating the transition to risk-based accountability. Equality Health supports over 800,000 members and more than 4,000 practice sites and continues to scale rapidly. In 2021, Equality Health partnered with General Atlantic, a leading global growth equity firm, to help drive continued expansion and fuel the next phase of growth as a leading value-based primary care network serving the Medicaid, Medicare and ACA Exchange populations. This strategic investment will enable Equality Health to pursue further geographic expansion, technological innovation and product development while furthering its mission of increasing access to care, lowering costs and improving outcomes for underserved individuals, families and communities. About the Role: The Senior Actuarial Analyst is responsible for leading advanced actuarial analytics and health economics evaluations that measure financial and clinical outcomes across organizational programs. This role expands upon core actuarial responsibilities by owning the design and execution of affordability analyses and ROI studies, particularly within Medicaid populations and value-based care arrangements. This individual will translate complex clinical and operational interventions into financial impact, develop methodologies for savings attribution, and provide strategic insights that influence payer performance, product strategy, and enterprise decision-making. Key Responsibilities: * Develop and enhance actuarial and health economic models to quantify program impact on cost, utilization, and quality outcomes.  * Own monitoring and evaluation of payer/provider-group performance across financial (MLR/MCR, PMPM) and operational/utilization metrics. * Translate performance results into actionable insights and recommendations to improve value-based contract outcomes.  * Support payer reporting and partner discussions with clear, defensible financial analyses. * Leverage and integrate multiple data sources (claims, eligibility, pharmacy, EMR, quality, care management) to produce comprehensive analyses * Identify key cost drivers, population health trends, and intervention opportunities, particularly within Medicaid populations. * Investigate and resolve complex data anomalies; establish best practices for data validation and reliability. * Translate analytical findings into executive-ready insights and narratives for internal and external stakeholders. * Continuously improve processes for scalability, automation, and reproducibility of analyses. Required Skills & Qualifications: * Bachelor’s degree in Mathematics, Statistics, Actuarial Science, Economics, or related field (or equivalent experience).  * 3-5+ years of healthcare analytics or actuarial experience.  * Strong experience with Medicaid data, including claims, encounters, eligibility, and capitation structures.  * Demonstrated experience in ROI analysis, health economics, or program evaluation.  * Advanced proficiency in SQL and Excel; experience with Python, R, or SAS preferred.  * Strong understanding of healthcare financial metrics (PMPM, MLR/MCR, risk scores) and utilization drivers.  * Experience working in value-based care or risk-based contracting environments.  * Strong communication skills with ability to present complex analyses to diverse audiences Preferred Skills & Qualifications: * Progress toward ASA  * Experience with causal inference or quasi-experimental methods (e.g., difference-in-differences, matching).  * Familiarity with Medicaid rate setting, risk adjustment models (e.g., CDPS), and regulatory environment.  * Demonstrated ability to manage multiple projects and operate independently in fast-paced environments.  * Strong systems thinking with ability to connect clinical programs to financial outcomes. Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.