Senior Healthcare Analyst, Actuarial

Company Overview

Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using leading edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health insurance plans covering over 15 million people, while our revenues and company size have quadrupled.  That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work, Top 5 LinkedIn™ Startup, TripleTree iAward, multiple KLAS Research Points of Light, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists

Opportunity overview

We are seeking a highly analytical and client-focused Senior Healthcare Analyst to join our Actuarial Department in Cohere Health. This role requires strong data analysis skills, deep knowledge of healthcare utilization and cost management, and the ability to effectively communicate complex actuarial concepts to both internal and external stakeholders.

The ideal candidate will have advanced client-facing experience, including the ability to manage high-pressure situations, respond to urgent client needs, and clearly articulate insights and recommendations to executive-level stakeholders.

At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Actuarial team and develop & maintain cost savings models.

Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

 What you will do:

• Data Analysis & Actuarial Support: Conduct in-depth analysis of utilization trends, cost drivers, and program impact assessments to support actuarial modeling and financial forecasting.
• Client Engagement & Communication: Act as a key liaison between the Actuarial team and clients, ensuring a clear understanding of methodologies, impact reports, and financial projections.
• Utilization & Program Impact Assessment: Evaluate healthcare intervention programs (e.g., nudge strategies, medical necessity determinations) and measure their impact on cost and utilization.
• Presentation & Reporting: Develop and present actuarial insights, impact reports, and financial analyses to clients, executives, and cross-functional teams.
• Cross-Functional Collaboration: Work closely with clinical, data science, business intelligence, and product teams to ensure alignment on methodologies and data integrity.
• Issue Resolution & Risk Mitigation: Handle client inquiries, troubleshoot discrepancies in reporting, and manage high-stakes client discussions in stressful or time-sensitive situations.
• Process Improvement: Identify opportunities to enhance automation, streamline reporting, and improve actuarial analysis methodologies.

Your background & requirements: 

• 5-8 years of experience in healthcare analytics, cost containment, or similar roles in the healthcare industry, preferably within a payer, provider, or managed care setting.
• Familiarity with prior authorization, utilization management processes is highly desirable.
• Strong understanding of healthcare cost drivers, claims data, and prior authorization processes required.
• Proficiency in SQL, Python, R, Excel, and data visualization tools (e.g., Tableau, Power BI).
• Strong client-facing experience, with the ability to navigate challenging conversations and high-pressure situations.
• Excellent communication, storytelling, and presentation skills, particularly when explaining complex actuarial findings to non-technical audiences.
• Strong data interpretation, statistical analysis and problem-solving skills 
• Ability to transform complex data into actionable insights and clear, concise reports.
• Excellent interpersonal skills to work with end users to develop QC metrics
• Passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible.
• Self-starter, able to work independently, able to succeed in a fast-paced, high intensity start-up environment

We can’t wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement 

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all.  To us, it’s personal.

The salary range for this position is $100,000 to $115,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

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