Senior Actuarial Analyst

Who we are
At Bon Secours Mercy Health Global Business Services – Manila, we believe your best is yet to come. Based in the Philippines, we partner with U.S.-based teams to deliver strategic insights, operational excellence and specialized expertise that advance our Mission. Join a global team focused on meaningful healthcare impact.

Job Summary
The Senior Actuarial Analyst is responsible for delivering advanced financial and data analysis to support value-based managed care contracting and payer strategy. This role drives business impact through financial modeling, contract performance evaluation, reconciliation and data-driven insights that inform negotiation strategy and enterprise decision-making.
Operating within a Global Business Services environment, this role supports cross-functional collaboration, operational excellence and service delivery outcomes across U.S. healthcare operations.

What you'll do

• Analyze reimbursement structures and financial performance to support payer negotiations and strategy development
• Design and evaluate value-based payment models including shared savings, risk arrangements and quality-based incentives
• Develop financial models and pro forma analyses to assess contract changes, cost trends and performance opportunities
• Perform sensitivity and scenario analysis to estimate financial outcomes under varying cost and utilization assumptions
• Monitor contract and program performance to identify underpayments, compliance gaps and financial risks
• Prepare monthly forecasts, performance reports and variance analyses for value-based programs
• Conduct quarterly and annual reconciliation audits to validate payer compliance and contract performance
• Investigate discrepancies and support dispute resolution and appeals processes related to payment variances
• Build and enhance analytical tools and methodologies to track healthcare trends and forecast performance
• Translate complex data into actionable insights to support payer negotiations and leadership decision-making
• Create executive-ready reports and data visualizations for clinical and financial stakeholders
• Standardize and scale analytical processes across multiple programs and contracts
• Mentor analysts and provide technical guidance to improve team capabilities and output quality
• Collaborate with cross-functional teams including finance, operations and clinical stakeholders

What you'll bring

Experience

• 5+ years of experience in healthcare finance, payer analytics, medical economics or related field required
• Experience supporting value-based contract development and performance tracking required
• Experience in financial forecasting, audit and predictive analytics required
• Proven ability to analyze large healthcare claims, reimbursement or performance datasets required
• Track record of delivering analytics that inform business decisions required

Education

• Bachelor’s degree in Business Administration, Finance, Accounting, Healthcare Administration, Economics, Information Systems or related field required
• Master’s degree in Business Administration, Healthcare Administration, Public Health, Finance or related field preferred

Certifications

• Certified Healthcare Financial Professional (CHFP) – Healthcare Financial Management Association preferred
• Certified Professional in Healthcare Quality (CPHQ) – National Association for Healthcare Quality preferred

Skills

• Strong knowledge of managed care contracts, payment methodologies and reimbursement analytics
• Advanced Microsoft Excel skills including financial modeling, PivotTables and scenario analysis
• Proficiency in data visualization tools such as Power BI or Tableau
• Working knowledge of SQL or similar data querying tools preferred
• Strong analytical thinking and problem-solving skills
• Ability to interpret complex contract terms and translate into financial impact
• Strong communication skills with ability to present technical data to non-technical audiences
• High attention to detail and ability to manage multiple priorities independently
• Ability to synthesize data from multiple internal and external sources to inform strategy
• Strong collaboration and stakeholder management skills
• Commitment to maintaining data confidentiality and compliance with healthcare standards

What we offer
Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
One-time Work From Home allowance, connectivity allowance and wellness allowance
Paid vacation and sick leave
Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
Flexible working model based on role and business need
Mission-driven culture events, outreach and service opportunities
Learning and development programs, mentorship and career growth pathways
Collaborative office spaces and engagement activities

Benefits may vary based on employment terms and role.