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Role Summary

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HIGHLIGHTS

Senior health actuarial analyst focused on Medicare risk adjustment, pricing/financial analysis, and executive reporting. You will produce risk-adjustment estimates, develop risk score reporting, support forecasts/filings, and partner with operational teams across the organization. Role based in the United States, requiring strong data management and Power BI experience.

JOB DESCRIPTION SUMMARY

Lead Medicare risk adjustment estimates and risk score reporting
Perform pricing/financial analysis to support payer/provider negotiations
Build reports and dashboards with Power BI and Cozeva
Manage large healthcare datasets and communicate results to leadership
Mentor and peer-review junior actuarial analysts

DOMAIN EXPERTISE

Medicare risk adjustment
risk score reporting and analysis
financial modeling for payer and provider negotiations
experience with managed care systems (Epic, Cerner, GE Centricity)

KEY REQUIREMENTS

5+ years working with data and actuarial models
Expertise in Medicare risk adjustment estimates and reporting
Experience with managed care applications (GE Centricity, Epic, Cerner)
5+ years in financial modeling for payer/provider negotiations
Bachelor's degree in a quantitative discipline required

TECH STACK

Power_BI
Other_BI_Tool