UNKNOWN

FEED

YEAR

Support clinical and network analytics, including provider performance, care model effectiveness, and affordability initiatives in partnership with Clinical and Network teams. This role partners closely with Finance, Healthcare Economics, Clinical, and Network teams to evaluate performance, manage risk, and advance CINQCARE’s analytics capabilities.

Why Join CINQCARE?CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care.Position OverviewThe Senior Actuary, Actuarial Analytics and Reporting role is a high-impact analytical role responsible for supporting financial, actuarial, and strategic analytics across CINQCARE’s value-based care portfolio. This role partners closely with Finance, Healthcare Economics, Clinical, and Network teams to evaluate performance, manage risk, and advance CINQCARE’s analytics capabilities. This position reports to the Director, Actuarial Analytics and Reporting. The Senior Actuary role should embody CINQCARE's core values, including Trusted, Empathetic, Committed, Humble, Creative, and Community­ Minded.Key Responsibilities· Perform actuarial analyses across Medicare Advantage, Medicaid, and ACO (REACH, MSSP) populations, including pricing/underwriting, IBNR development, forecasting, and trend analysis.· Support monthly close and financial reporting processes, including P&L development, variance analysis, and performance tracking against budget and forecast.· Analyze financial and operational performance, identifying key drivers of variance across revenue, utilization, unit cost, risk adjustment, and quality.· Develop pro forma analyses and multi-year projections for new and renewing business, incorporating assumptions related to membership, reimbursement, medical cost, and operational factors.· Interpret and operationalize value-based contract terms, including capitation, shared savings/losses, and risk corridors, and support ongoing contract performance monitoring.· Analyze large healthcare datasets, including claims, encounter, and enrollment data, as well as Medicare Advantage (MMR, MOR, MA004) and ACO (BCDA, CCLF) data sources.· Apply knowledge of risk adjustment coding (HCC/RAF), and reimbursement structures (DRG, HCPCS/CPT, groupers) to financial and utilization analyses.· Perform risk adjustment analytics, including RAF score monitoring and revenue impact analysis.· Support clinical and network analytics, including provider performance, care model effectiveness, and affordability initiatives in partnership with Clinical and Network teams.· Conduct ad hoc and enterprise analytics to support executive leadership, corporate strategy, and investor-related initiatives.· Collaborate with Data and Technology teams to support development of predictive models and scalable analytics infrastructure.· Continuously improve analytical processes, tools, and methodologies to enhance accuracy, efficiency, and scalability.· Stay current on trends in value-based care, including Medicare Advantage, Medicaid, MSSP, ACO REACH, and evolving CMS models.Required Qualifications· Education: Bachelor’s degree in Mathematics, Statistics, Actuarial Science or related field.· Fellow of Society of Actuaries (FSA) preferred, Associate of Society of Actuaries (ASA) required.· Experience: 5+ years of actuarial, financial, or healthcare analytics experience. Experience in health insurance, consulting, or value-based care environments strongly preferred.· Medicare and/or Medicaid claims data and ACO models, including MSSP / REACH experience.· Key actuarial functions such as IBNR, pricing, forecasting, and trend analysis experience.· Familiarity with risk adjustment models (HCC/RAF), provider contracting, and value-based payment models.· Technical Skills: Superior Excel, data retrieval (SQL / SAS / Python), and PowerPoint skills.· Strong analytical and problem-solving capabilities.· Ability to translate complex financial and healthcare data into clear, actionable insights.· Soft Skills: Strong written and verbal communication skills.· Ability to manage multiple priorities and operate effectively in a fast-paced environment.· High attention to detail with strong business judgment and ownership.· Excellent relationship management skills with a persuasive communication style.· Self-motivated and results-driven, with an ability to thrive in a fast-paced, growth-oriented environment. The working environment and physical requirements of the job include:In-office work is performed indoors in a traditional office setting with conditioned air, artificial light, and an open workspace.In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.Equal Opportunity & Reasonable Accommodation StatementCINQCARE is an Equal Opportunity Employer committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.If you require a reasonable accommodation during the application or employment process, please indicate this in your application or speak with your recruiter during the hiring process.DisclaimerThis job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary. Our Benefits At CINQCARE, we care for our team like we care for our patients—holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.<ul><li>Medical Plans: Two comprehensive options offered to Team members.</li><li>401K: 4% employer match for your future.</li><li>Dental & Vision: Flexible plans with in-network savings.</li><li>Paid Time Off: Generous PTO, holidays, and wellness time.</li><li>Extras: Pet insurance, commuter benefits, mileage reimbursement, CME for providers, and company-provided phones for field staff.</li></ul>

CINQCARE

Senior Actuary, Actuarial Analytics and Reporting

Accounting Close

Actuarial Skills

Alliance/Partner Management

Analysis Skills

Budget Management

Business Strategy

Centers for Medicare and Medicaid Services (CMS)

Cisco ASA (Adaptive Security Appliance)

Clinical Assessment

Communication Skills

Community Health

Consulting

Continuous Improvement

Contract Management

Data Modeling

Data Recovery

Data Sets

Detail Oriented

Diagnosis-Related Group (DRG)

Finance

Financial Analysis

Financial Operations

Flexible Spending Accounts

Forecasting

Health Economics

Health Insurance

Healthcare

Healthcare Common Procedure Coding System (HCPCS)

Healthcare Providers

Leadership

Mathematics

Medicaid

Medicare

Microsoft PowerPoint

Multitasking

Network Performance/Analysis

Network Support

Nursing

Operational Audit

Performance Analysis

Performance Modeling

Persuasion Skills

Predictive Modeling

Presentation/Verbal Skills

Pricing

Problem Solving Skills

Process Improvement

Profit & Loss

Provider Contracting

Python Programming/Scripting Language

Reimbursement

Relationship Management

Revenue Analysis

Revenue Growth

Risk

Risk Analysis

Risk Management

Risk Modeling

Royal Air Force

SQL (Structured Query Language)

Sales Management

Statistics

Strategic Analysis

Trend Analysis

Underwriting

Variance Analysis

Writing Skills

JobScore

OTHER

As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home. Contribute to and/or lead a wide variety of complex projects involving the contracting, reserving, pricing, and financial modeling of a full array of value-based care programs for providers and payors.

Overview:
<img alt="LI Teammate Cover - On A Mission" height="215" src="https://somatus.icims.com/icims2/servlet/icims2?module=AppInert&action=download&id=91545&hashed=-527906361" width="860"/><h3 style="margin:14.05pt 0in 14.05pt 0in">As a leading provider of outcomes-driven care for individuals and communities living with chronic conditions, Somatus is helping patients across the country enjoy More Healthy Days at Home. </h3>Care at Somatus goes beyond treatment. Through a whole‑person approach, we deliver outcomes‑driven integrated care and show up #SomatusStrong for our patients and teammates. We partner closely with health plans, health systems, and provider groups to support patients with, or at risk of developing, cardio, kidney, metabolic, or other chronic conditions.  We hire the brightest and boldest — talent driven by purpose and impact. Since our founding in 2016, our growth trajectory isn’t just a milestone — it’s a signal. Our leadership values culture and leads with intention as we remain dedicated to driving clinical excellence.   Does this sound like you? Keep reading.<h3 style="margin:12pt 0in 12pt 0in">How We’ll Support You: We offer 25+ health, growth, and wealth work perks to help teammates be the best version of themselves, including:</h3><ul><li style="margin-bottom:0in">Subsidized personal healthcare coverage: Medical, Dental & Vision, plus Wellness programs</li><li style="margin-bottom:0in">Paid Time Off: Flexible PTO</li><li style="margin-bottom:0in">Professional development: CEU and tuition reimbursement</li></ul> 

Responsibilities:
The Sr. Analyst, Actuary role will require the ability to evaluate complex risks and assess the potential financial consequences of those risks in the healthcare space. Utilize mathematics, statistics, and financial theory to assess the risk that may occur and help the business and clients develop business plans that minimize the cost of that risk. Advise the business on contract pricing in a value-based, risk-bearing environment. Contribute to and/or lead a wide variety of complex projects involving the contracting, reserving, pricing, and financial modeling of a full array of value-based care programs for providers and payors.<ul><li>Analyze statistical data around medical trends</li><li>Complex modelling of statistics to determine potential risks</li><li>Assist with pricing risk contracts with payors and providers</li><li>Prepare presentations and detailed reports and present to clients</li><li>Lead development and/or maintain multiple internal statistical models to support key business goals / initiatives; pricing models, financial projections, contract modeling, and ad hoc support projects</li><li>Strong quantitative and financial modeling capabilities and problem-solving ability</li><li>Ability to work both independently and lead small teams, while enjoying a fast-paced collaborative environment</li><li>Strong analytical skills including ability to draw conclusions, develop processes, and identify trends from data in a logical, systematic way</li><li>Create client reporting for actuarial topics like the financial outcomes of various contracts, including shared risk and contingency based contracts.</li><li>Lead development of advanced analytical models that help demonstrate our program value (cost savings, quality outcomes, and member satisfaction) to our clients</li><li>Strong written and verbal communication skills</li><li>Expert proficiency with Microsoft Suite to include SQL, Excel, Word, Power Point and Outlook</li></ul>This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Qualifications:
Qualifications:<ul><li>Bachelor's degree in actuarial science, mathematics, economics or a related field is required</li><li>Minimum of four (4) years of decision support, financial analysis or actuarial experience is required</li><li>Ability to work cross-functionally with a variety of teams including operations, product, and technology.</li><li>Strong database (SQL) experience is required</li></ul>Preferred Qualifications:<ul><li>4-7 years of experience</li><li>Associate in the Society of Actuaries (ASA) Preferred</li><li>Ability to handle ambiguity and desire to work in a fast-paced start-up environment.</li></ul>

Other Duties :
At Somatus, we celebrate what makes us unique — our people. We believe that a culture intentionally built to foster and support our unique passions, experiences, and perspectives helps fuel us in the pursuit of our mission.
Somatus, Inc. provides equal employment opportunity to all individuals regardless of race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by law. Discrimination of any type will not be tolerated.

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Actuary Jobs in Capitol, VA

Senior Actuary, Actuarial Analytics and Reporting CINQCARE

Senior Actuarial Analyst Somatus, Inc.

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