Risk Consulting - Actuarial - Healthcare Analytics and Model Validation - Senior

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Senior – Healthcare Analytics & Model Validation, EY GDS Consulting

Global Delivery Services is one of EY's greatest global assets – a network of service delivery centers that provide high-quality services at a competitive cost for all EY’s client serving and enablement teams. Every day, we combine our subject matter expertise with our technology and automation skills to develop new solutions that deliver greater value for EY. If you have a passion for enabling world class Actuarial and Analytics services globally to solve the most complex challenges in the financial services industry, come join our dynamic GDS team!

The opportunity

We are looking for a Senior to join our Actuarial and Analytics team delivering solutions to the leading clients in Insurance Sector, working closely with other Staff/Assistants, Consultants/Seniors, Managers, Senior Managers or Client partners in EY’s global network of insurance sector and consulting professionals.

Within our talented and dynamic team, the members work on multiple client engagement teams that perform healthcare analytics, predictive modeling, model governance and help organizations make better business decisions through data driven insights. The role will focus on independent model validation, healthcare analytics, and model risk management activities across financial, operational, predictive, forecasting, and AI/ML models. The team members also receive on-the-job training to acquire practical experience in addressing business/technical issues and in applying industry knowledge and EY policies/procedures on client engagements.

Within our growing team, members work alongside healthcare, actuarial, data science, and business stakeholders to assess model methodologies, assumptions, data quality, performance, documentation, and governance frameworks. The role offers an excellent opportunity to gain exposure to advanced analytical techniques, healthcare economics, predictive modeling, and emerging AI/ML applications while contributing to critical business decisions.

Our growing team of professionals comes from diverse backgrounds and is committed to being trusted advisors to our clients.

Your key responsibilities

As a Senior in Actuarial and Analytics team, your role involves developing and implementing solutions both within the Insurance service line and in collaboration with other services lines.  

On engagements, you will:

• Be responsible for providing high-quality results and generating effective solutions, working along with Senior Consultants, Managers and Senior Managers in delivering the project.
• Provide focused solutions and training to Staff members.
• Be responsible for ensuring all engagements are delivered within the designated time.
• Deliver engagements in line with EY values and commitment to quality and ensuring that work is of high standards.
• Manage day-to-day priorities, provide regular status updates, and accurately track and report project KPIs to support project delivery.
• Collaborate effectively with client teams, data scientists, business users, and other EY professionals.

Within the actuarial and analytics practice you will:

• Validate healthcare cost forecasting and claims prediction models.
• Review claims cost and utilization forecasting methodologies.
• Assess budget planning and financial forecasting models.
• Evaluate reimbursement optimization and revenue cycle analytics models.
• Review Fraud, Waste and Abuse (FWA) detection models and analytical frameworks.
• Support validation of AI/ML models used in healthcare decision-making.
• Analyze large healthcare datasets to identify trends, anomalies, and model performance issues.
• Perform ad hoc analytical projects and research activities.
• Stay informed of current developments in healthcare analytics, predictive modeling, AI/ML, and model governance.
• Stay informed of current business/economic developments relevant to the industry/geography.

We are looking for individuals who have a proactive attitude and are seeking the opportunity for personal and professional growth, leveraging and supporting our global network.

Skills and attributes for success

Skills and attributes for a successful career at EY require analytical rigor, intellectual curiosity, strong problem-solving abilities, the ability to communicate complex findings clearly to technical and non-technical audiences, having a learning mindset and passion to add value to GDS, member firms and client organizations. Bright and enthusiastic individuals who give their all to each assignment they work on will find themselves at home within our energetic GDS Actuarial and Analytics team.

We are looking for professionals who:

• Demonstrate strong attention to detail and analytical thinking.
• Can independently investigate and challenge model assumptions.
• Have excellent written and verbal communication skills.
• Thrive in collaborative and client-facing environments.
• Are passionate about continuous learning and innovation.
• Can manage multiple priorities while maintaining high-quality standards.

To qualify for the role, you must have

• 3+ years of experience in healthcare analytics, predictive modelling, model validation, actuarial analytics, risk analytics, data science, or related quantitative fields.
• Bachelor's or Master's degree in Statistics, Mathematics, Actuarial Science, Data Science, Economics, Engineering, Computer Science, or a related quantitative discipline.
• Strong understanding of statistical, forecasting, predictive modelling, and machine learning techniques.
• Advanced proficiency in Microsoft Excel, including PivotTables, Power Query, advanced formulas, data modelling, data validation, and VBA/macros.
• Strong analytical and problem-solving capabilities.
• Ability to multi-task and flexible work attitude packed with good analytical skills.
• Ability to interpret complex quantitative results and communicate findings effectively.

Ideally, you’ll also have

• Experience in US healthcare, health insurance, or managed care organizations.
• Exposure to healthcare claims analytics, medical cost forecasting, utilization management, or provider analytics.
• Experience reviewing AI/ML models and predictive analytics solutions.
• Familiarity with Model Risk Management (MRM) frameworks and model governance standards.
• Knowledge of Medicare, Medicaid, commercial health insurance, and provider reimbursement processes.
• Experience in presenting analytical findings and validation conclusions to senior stakeholders.
• Exposure to cloud-based analytics platforms and modern data ecosystems.
• Strong SQL skills and experience working with large datasets.
• Experience using Python and/or SAS for analytics, model development, or validation activities.
• Experience performing data quality reviews and quantitative testing.
• Experience of handling a small team will be an advantage.
• AI Literacy – Good knowledge on GenAI, Agentic AI would be an added advantage

What we look for

• Strong knowledge of healthcare analytics, predictive modeling, data science, and model validation practices.
• Deep knowledge and experience of the insurance industry and/or consulting. Relevant recent healthcare analytics experience in leading engagement with recognized health insurers and healthcare service providers.
• Up to date knowledge of the regulatory environment impacting insurers and other financial service organizations.

What we offer

EY Global Delivery Services (GDS) is a dynamic and truly global delivery network. From accountants to coders to advisory consultants, we offer a wide variety of fulfilling career opportunities that span all business disciplines. In GDS, you will collaborate with EY teams on exciting projects and work with well-known brands from across the globe. We’ll introduce you to an ever-expanding ecosystem of people, learning, skills and insights that will stay with you throughout your career.

• Continuous learning: You’ll develop the mindset and skills to navigate whatever comes next.
• Success as defined by you: We’ll provide the tools and flexibility, so you can make a meaningful impact, your way.
• Transformative leadership: We’ll give you the insights, coaching and confidence to be the leader the world needs.
• Diverse and inclusive culture: You’ll be embraced for who you are and empowered to use your voice to help others find theirs.

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