About us:

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 Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. 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: 

Seeking a motivated and detail-oriented analyst to join our team. This position is ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical skills to support key business functions such as pricing, reserving, forecasting, and risk analysis.

Primary Job Responsibilities

• Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis
• Perform data analysis and experience studies using large datasets from internal and external sources
• Support the preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses
• Collaborate with cross-functional teams including finance, claims, sales, and product development to evaluate the impact of benefit changes, provider contracts, and regulatory updates
• Document assumptions, methodologies, and results in compliance with ASOPs, CMS guidance, and state/federal requirements
• Contribute to the automation and streamlining of actuarial processes
• Stay current with industry trends, regulatory changes, and professional standards

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 work independently and as part of a team
• Proficiency in Excel; experience with actuarial software (e.g. – SAS, SQL, Python, VBA) is a plus
• Familiarity with insurance products and regulatory environments
• Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development

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.