Fallon Health
Actuarial Analyst- Growing Healthcare Organization
Fallon Health, Worcester, Massachusetts, us, 01609
Overview
About us:
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.
Brief Summary of Purpose:
Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical skills to support key business functions such as pricing, reserving, forecasting, and risk analysis.
Responsibilities Primary Job Responsibilities
Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis
Perform data analysis and experience studies using large datasets from internal and external sources
Support the preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses
Collaborate with cross-functional teams including finance, claims, sales, and product development to evaluate the impact of benefit changes, provider contracts, and regulatory updates
Document assumptions, methodologies, and results in compliance with ASOPs, CMS guidance, and state/federal requirements
Contribute to the automation and streamlining of actuarial processes
Stay current with industry trends, regulatory changes, and professional standards
Qualifications Education:
BS or BA in Actuarial Science, Mathematics, Statistics, Finance, Economics or related field.
License/Certifications:
Passage of at least two Society of Actuaries exams is required.
Experience:
The ideal candidate must possess:
Excellent quantitative, problem-solving, and analytical skills
Attention to details and ability to learn quickly
Well-developed oral and written communication skills
Ability to work independently and as part of a team
Proficiency in Excel; experience with actuarial software (e.g. – SAS, SQL, Python, VBA) is a plus
Familiarity with insurance products and regulatory environments
Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development
Fallon 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.
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Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.
Brief Summary of Purpose:
Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical skills to support key business functions such as pricing, reserving, forecasting, and risk analysis.
Responsibilities Primary Job Responsibilities
Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis
Perform data analysis and experience studies using large datasets from internal and external sources
Support the preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses
Collaborate with cross-functional teams including finance, claims, sales, and product development to evaluate the impact of benefit changes, provider contracts, and regulatory updates
Document assumptions, methodologies, and results in compliance with ASOPs, CMS guidance, and state/federal requirements
Contribute to the automation and streamlining of actuarial processes
Stay current with industry trends, regulatory changes, and professional standards
Qualifications Education:
BS or BA in Actuarial Science, Mathematics, Statistics, Finance, Economics or related field.
License/Certifications:
Passage of at least two Society of Actuaries exams is required.
Experience:
The ideal candidate must possess:
Excellent quantitative, problem-solving, and analytical skills
Attention to details and ability to learn quickly
Well-developed oral and written communication skills
Ability to work independently and as part of a team
Proficiency in Excel; experience with actuarial software (e.g. – SAS, SQL, Python, VBA) is a plus
Familiarity with insurance products and regulatory environments
Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development
Fallon 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.
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