Role Summary

HIGHLIGHTS

Senior health actuarial analyst focused on risk adjustment retrospective analytics for Medicare Advantage and ACA chart review programs in Oakland, CA. You will develop chart targeting lists, quantify financial impact, build predictive models, and support reserves and financial forecasting. Reports to the Manager of Risk Adjustment Retrospective Analytics in a hybrid work model.

JOB DESCRIPTION SUMMARY

Lead retrospective risk adjustment analytics for Medicare Advantage and ACA chart review
Develop chart targeting, quantify program financial impact, and validate vendor data
Build predictive models and forecasting using R, Python, SQL or SAS
Senior role requiring 6+ years actuarial experience, reporting to the Analytics Manager
Hybrid role — office presence required at least two times per month (Oakland, CA)

DOMAIN EXPERTISE

Medicare Advantage chart review analytics
ACA chart review analytics
Healthcare enrollment and claims processing experience
Revenue and expense accounting experience

KEY REQUIREMENTS

6+ years of professional actuarial experience
Bachelor’s degree required (math, statistics, CS minor or equivalent)
Healthcare enrollment and claims processing and finance experience required
Proficiency with MS Office (Excel, Word, PowerPoint)
Strong ability to create and validate analytic processes and communicate to executives