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Fallon Health Sr. Actuarial Analyst - Growing Healthcare Organization - REMOTE in Worcester, Massachusetts


About Fallon Health:

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 delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. 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 :

The Sr. Actuarial Analyst assists the actuarial services department to develop best-practice actuarial models and promote their implementation; assists in conducting actuarial studies and developing recommended rate action; provides data and analytic expertise to support actuarial services including financial reporting, experience analysis, trend development, rating, reserving and forecasting. The analyst is able to perform assigned duties with regular management oversight of select tasks and processes.

The Sr. Actuarial Analyst will provide analytical and technical support to project teams, manage projects, and mentor more junior staff.

The Sr. Actuarial Analyst will be able to refine and collect appropriate data for actuarial analysis, to ensure its reasonableness and accuracy by coordination within the division, to apply the appropriate actuarial analytical tools to the data and to perform actuarial and statistical analysis. The analyst will provide data/analytic expertise to support actuarial services including financial reporting, trend analysis, utilization studies, rate development and claims liability estimates. The candidate will be able to suggest and implement updates to pricing, valuation and forecasting models.

The Sr. Actuarial Analyst will anticipate and meet, or exceed, internal and/or external customer expectations and requirements; establish and maintain effective relationships with customers and gain their trust and respect.

The Sr. Actuarial Analyst will continue to develop their actuarial skill set and must be on track to being credentialed. Candidate will demonstrate exam progress to qualify for study time, cost of materials, and incentives for passing exams.


Job Responsibilities:

The Sr. Actuarial Analyst may be assigned to perform actuarial analyses for Fallon’s various lines of business including, but not limited to: medical expense and revenue analyses and projections, determining rates and preparing supporting documentation for rate filings, building and maintaining rate models, analyzing data in support of monthly reserve process, and ad hoc actuarial analyses.Responsibilities include:

  • Assist the Actuarial Services staff and management with a variety of projects including pricing, reserving, trend evaluation, data gathering, and financial analysis,

  • Assist other Actuarial Services team members with projects as needed

  • Perform forecasting and financial analysis

  • Health insurance pricing and rate filings

  • Perform or support trend analysis

  • Develop communication and presentation skills

  • Ensure compliance with actuarial standards of practice and principles

  • Support regulatory reporting as needed

  • Other duties as assigned



BS or BA in Actuarial Science, Mathematics, Statistics, Finance, Economics or Computer Science required.


Passage of at least four Society of Actuaries exams is required.


At least two years of relevant Actuarial experience is required.

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 facilitate planning and review sessions.

  • Solid presentation skills; ability to present to senior level department management and project teams.

  • Ability to operate in a matrixed environment.

  • Ability to identify roadblocks and participate in their resolution.

  • Ability to implement Actuarial department standards and processes.

  • Ability to apply own judgment on most analytical and technical issues with input on organization and implementation of project and processes.

  • Knowledge of MS-Office products, particularly Excel, is required. Familiarity with SQL or SAS desired.

  • Accountable for delivering high quality work.

  • Commitment to successfully progressing in the actuarial exam program administered by the Society of Actuaries.

Fallon Health Vaccination Requirements:

To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022 all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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.

Location US-MA-Worcester

Posted Date 3 weeks ago (1/5/2023 2:15 PM)

Job ID 7156

# Positions 1

Category Finance