athenahealth
Director, Actuarial Analytics – Healthcare Utilization & Revenue Forecasting
athenahealth, Austin, Texas, us, 78716
Business Title
Director, Actuarial Analytics – Healthcare Utilization & Revenue Forecasting
Role Summary The Director of Actuarial Analytics will lead the development and execution of advanced actuarial models and analytics to forecast healthcare utilization, evaluate emerging trends, and assist the broader FP&A team in projecting revenue. This role will provide strategic insights to executive leadership, guide business initiatives, and ensure the organization’s financial planning is grounded in robust actuarial analysis. It reports to the Executive Director of Corporate Finance.
Team Summary The FP&A team builds budgets, forecasts, and multi‑year financial plans that guide the company’s strategic priorities. This actuarial‑focused director partners closely with finance, product, sales, and operations to translate utilization and pricing insights into reliable forecasts and actionable financial models.
Essential Job Responsibilities
Develop and lead actuarial forecasting models for utilization, revenue, and cost across products and lines of business.
Manage pricing analyses and rate‑setting workstreams for government (Medicare, Medicaid) contracts and commercial payer models.
Analyze utilization trends and identify drivers to inform financial projections and strategic recommendations.
Build and maintain financial models and dashboards to support monthly/quarterly forecasting and executive reporting.
Collaborate with sales, product, and operations to evaluate contract economics, renewals, and new business opportunities.
Mentor and review work from actuarial and analytics staff, ensuring methodological rigor and quality control.
Present findings and recommendations to senior finance and business leaders to support strategic decision‑making.
Support development of actuarial documentation and knowledge sharing across the finance organization.
Additional Job Responsibilities
Support ad hoc actuarial analyses for M&A, strategic investments, or special projects as requested.
Contribute to process improvements in forecasting, pricing, and reporting workflows.
Partner with regulatory and compliance teams on modeling assumptions related to reimbursement and policy changes.
Prepare documentation and assumptions for audit and external reporting needs.
Participate in vendor and third‑party model evaluations and oversight.
Expected Education & Experience
Bachelor’s degree in Actuarial Science, Statistics, Mathematics, or related field (Master’s preferred).
Associate or Fellow of the Society of Actuaries (ASA or FSA).
8+ years of experience in healthcare actuarial roles, with deep expertise in forecasting, pricing, and utilization analysis.
Experience with government healthcare contracts (Medicare, Medicaid) and commercial payer models.
Advanced proficiency in Excel, SQL, SAS, and other analytical tools; experience with data visualization platforms (e.g., Power BI, Tableau) preferred.
Strong communication skills, with the ability to present complex analyses to non‑technical audiences.
Demonstrated leadership in managing projects and mentoring teams.
Creative problem‑solving skills and intellectual curiosity; ability to thrive in a fast‑paced, evolving environment.
Experience with value‑based contracting and risk adjustment analytics.
Prior consulting experience or exposure to multiple payer environments preferred.
Proven ability to integrate actuarial standards with business strategy and operational goals.
Pay Range Pay range information is available per location.
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Role Summary The Director of Actuarial Analytics will lead the development and execution of advanced actuarial models and analytics to forecast healthcare utilization, evaluate emerging trends, and assist the broader FP&A team in projecting revenue. This role will provide strategic insights to executive leadership, guide business initiatives, and ensure the organization’s financial planning is grounded in robust actuarial analysis. It reports to the Executive Director of Corporate Finance.
Team Summary The FP&A team builds budgets, forecasts, and multi‑year financial plans that guide the company’s strategic priorities. This actuarial‑focused director partners closely with finance, product, sales, and operations to translate utilization and pricing insights into reliable forecasts and actionable financial models.
Essential Job Responsibilities
Develop and lead actuarial forecasting models for utilization, revenue, and cost across products and lines of business.
Manage pricing analyses and rate‑setting workstreams for government (Medicare, Medicaid) contracts and commercial payer models.
Analyze utilization trends and identify drivers to inform financial projections and strategic recommendations.
Build and maintain financial models and dashboards to support monthly/quarterly forecasting and executive reporting.
Collaborate with sales, product, and operations to evaluate contract economics, renewals, and new business opportunities.
Mentor and review work from actuarial and analytics staff, ensuring methodological rigor and quality control.
Present findings and recommendations to senior finance and business leaders to support strategic decision‑making.
Support development of actuarial documentation and knowledge sharing across the finance organization.
Additional Job Responsibilities
Support ad hoc actuarial analyses for M&A, strategic investments, or special projects as requested.
Contribute to process improvements in forecasting, pricing, and reporting workflows.
Partner with regulatory and compliance teams on modeling assumptions related to reimbursement and policy changes.
Prepare documentation and assumptions for audit and external reporting needs.
Participate in vendor and third‑party model evaluations and oversight.
Expected Education & Experience
Bachelor’s degree in Actuarial Science, Statistics, Mathematics, or related field (Master’s preferred).
Associate or Fellow of the Society of Actuaries (ASA or FSA).
8+ years of experience in healthcare actuarial roles, with deep expertise in forecasting, pricing, and utilization analysis.
Experience with government healthcare contracts (Medicare, Medicaid) and commercial payer models.
Advanced proficiency in Excel, SQL, SAS, and other analytical tools; experience with data visualization platforms (e.g., Power BI, Tableau) preferred.
Strong communication skills, with the ability to present complex analyses to non‑technical audiences.
Demonstrated leadership in managing projects and mentoring teams.
Creative problem‑solving skills and intellectual curiosity; ability to thrive in a fast‑paced, evolving environment.
Experience with value‑based contracting and risk adjustment analytics.
Prior consulting experience or exposure to multiple payer environments preferred.
Proven ability to integrate actuarial standards with business strategy and operational goals.
Pay Range Pay range information is available per location.
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