Sr. Actuarial Analyst - Risk Adjustment

Overview

Support risk adjustment initiatives through data analysis, modeling, actuarial reporting, and data validation. This non-traditional actuarial role is part of an actuarial development program and focuses on data completeness and accuracy to estimate outcomes and support business decisions.

This position is fully remote within the continental U.S., with ET and CT time zones preferred.

Responsibilities

• Run and analyze market-level results using CDPS+Rx or similar risk adjustment models.
• Serve as the team’s point of contact for an assigned group of markets.
• Apply knowledge of mathematics, probability, statistics, finance, and business to calculate financial outcomes.
• Assist with developing probability tables based on analysis of statistical data and other pertinent information.
• Analyze and evaluate required premium rates.
• Develop and run data reports.
• Support risk adjustment initiatives, including:
  • Data submissions
  • Rate reconciliation
  • Audits
  • Chart chase programs
• Identify data issues, uncover meaningful insights, and communicate findings to support business decisions.
• Perform other duties as assigned and comply with all policies and standards.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.
• Actuarial experience with demonstrated progress toward an actuarial credential through successful completion of actuarial exams.

Preferred Qualifications

• Experience with data validation, manipulation, and quality assurance.
• Strong SQL, coding, and data analytics skills working with large datasets.
• Experience with risk adjustment models, SAS, Snowflake, healthcare data, and process automation.

Compensation & Benefits

• Pay Range: $70,100 - $126,200 per year
• Comprehensive benefits package, which may include:
  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field, or office schedules
• Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.
• Total compensation may include additional forms of incentives.
• Benefits may be subject to program eligibility.

Location

Fully remote within the continental U.S.; ET and CT time zones preferred.