Remote Risk Analyst Jobs in Lexington, MA (NOW HIRING)

Site: Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.
We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. We offer a comprehensive actuarial development program designed to support continued exam progression, including paid study time, exam reimbursement, and structured salary increases tied to exam achievement.
The Government Programs Actuarial Analyst II position will serve as the subject matter expert for the Medicare and Dual Eligible lines of business. Under the supervision and guidance of the Director, Actuarial Reserving, Forecasting & Risk Management Support, this role will support key actuarial functions such as valuation, pricing, and forecasting. The individual will have cross-functional responsibilities to coordinate the analytics and reporting to monitor claims and risk score trends, as well as effectively communicate financial performance to business leadership.
Essential Functions
-Lead monthly reserving process (IBNR and other actuarial accruals) and communication of financial results and variances to the budget to senior leadership.
-Support quarterly forecasting of Medicare and D-SNP for Premium Deficiency Reserve calculation, Budget, and Forecast, including analysis of trends, assumptions, and key drivers
-Contribute to the development and successful completion of Medicare and D-SNP Bid, including data preparation, pricing support, and documentation
-Support regulatory and financial reporting requirements, including annual external audits, DOI audits, and various recurring Medicare and D-SNP filings
-Develop and enhance actuarial analyses and reporting, including pricing studies, dashboards, and presentations that provide insights into financial performance, risk factors, and profitability.
-Monitor and evaluate emerging risks to financial performance, including claims trends and changes in regulations.
-Collaborate with leadership and cross-functional teams to apply actuarial concepts, deliver high-quality work, and ensure accountability to deadlines and commitments.
-Perform other duties as assigned with or without accommodation.
Qualifications

• Bachelor's degree in Mathematics, Statistics or another quantitative discipline (Physics, Engineering, Quantitative Finance, Mathematical Economics, etc.) required
• Minimum of 2+ years of full-time actuarial experience in a healthcare or insurance setting
• At least 1-2 years of healthcare actuarial experience required, ideally supporting Medicare Advantage, DSNP, or government programs

Knowledge, Skills, and Abilities

• Proficiency in Microsoft Office, VBA, SQL, and SAS.
• Strong written and oral communication skills, with the ability to convey actuarial concepts to non-technical stakeholders
• Demonstrated knowledge of actuarial concepts, techniques, and methodologies
• Strong understanding of insurance principles, products, and pricing concepts
• Strong analytical and problem-solving skills, with the ability to interpret complex data and perform quantitative analyses
• Excellent mathematical and statistical skills, with a keen attention to detail
• Strong organizational and time management skills, with the ability to manage multiple projects and meet deadlines

Additional Job Details (if applicable)
Working Conditions

• This is a remote role that can be done from most US states
• This is a full-time, Monday through Friday role with 5 eight-hour days
• Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees

Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$63,648.00 - $92,570.40/Annual
Grade
6
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.