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Manager of Actuarial Analytics – Healthcare Utilization & Revenue Forecasting

Position Summary:

The Manager of Actuarial Analytics will develop and apply advanced actuarial models and analytics to forecast healthcare utilization, assess emerging trends, and support revenue projections in partnership with the FP&A team. This role will deliver actionable insights to leadership and help ensure financial planning is informed by strong actuarial rigor. This position reports to the Director of Actuarial Analytics.

About the Team:

The FP&A team partners across the business to turn financial data into actionable insights that drive strategic decision-making and operational performance. They own forecasting and budgeting (including cash flow and three-statement models), produce executive-level reporting and scenario analysis for the CEO/CFO, and translate company priorities into measurable financial plans and KPIs.

Essential Job Responsibilities:

Healthcare Utilization Forecasting:

• Design and maintain actuarial models to forecast healthcare utilization across the payer landscape (Medicare, Medicaid, Commercial, etc.).

• Analyze historical and emerging trends in healthcare delivery, utilization, and cost drivers.

• Quantify and communicate drivers of variance to financial plans by specialty and payers.

Revenue Projection & Financial Analysis:

• Project revenue as a function of healthcare utilization, integrating actuarial standards and external trend information.

• Inform quarterly and annual financial forecasts with actuarially sound inputs.

• Evaluate the impact of legislative, regulatory, and market changes on revenue and utilization.

Trend Evaluation & Strategic Insights:

• Conduct studies to identify early signs of adverse trends or opportunities for improvement.

• Present findings and actionable recommendations to executive leadership and cross-functional teams.

• Lead actuarial analysis of market trends, competitor strategies, and payer landscape changes.

Model Development & Performance Measurement:

• Build, improve, and document models used for financial forecasting.

• Enhance predictive analytics and proprietary algorithms to optimize outcomes.

Stakeholder Engagement & Leadership:

• Collaborate with market leadership, clinical operations, IT, and finance teams to align analytics with business needs.

Expected Education & Experience:

• Bachelor’s degree in Actuarial Science, Statistics, Mathematics, or related field.

• Associate of the Society of Actuaries (ASA) required; FSA preferred.

• 5+ years of experience in healthcare actuarial roles, with expertise in forecasting, utilization analysis, and financial modeling.

• 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.

• Excellent verbal and written communication skills, with the ability to present complex analyses to non-technical audiences.

• Ability to collaborate across functions and work effectively with senior leadership and various business units.

• Creative problem-solving skills and intellectual curiosity; ability to thrive in a fast-paced, evolving environment.

• Exposure to multiple payer environments, preferred.

• Proven ability to integrate actuarial standards with business strategy and operational goals, preferred.

• Ability to leverage AI‑enabled tools, or show a strong eagerness to develop proficiency in them, to improve efficiency, scale insights, and streamline analytical and presentation workflows, preferred.

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Expected Compensation

The base salary range shown reflects the full range for this role from minimum to maximum. At athenahealth, base pay depends on multiple factors, including job-related experience, relevant knowledge and skills, how your qualifications compare to others in similar roles, and geographical market rates.  Base pay is only one part of our competitive Total Rewards package - depending on role eligibility, we offer both short and long-term incentives by way of an annual discretionary bonus plan, variable compensation plan, and equity plans.