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Role Summary

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HIGHLIGHTS

Senior health actuarial role focused on Medicare Advantage risk adjustment in Chicago. You’ll analyze CMS and claims data, reconcile RAF leakage, build financial models and business cases, and present findings to senior leadership. Requires 4+ years in risk adjustment and 3+ actuarial exams passed. Hybrid role with remote flexibility and in-person needs in Chicago.

JOB DESCRIPTION SUMMARY

  • Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
  • Analyze CMS datasets (MMR, MOR, MAO-004) and medical claims
  • Build scenarios, forecasts, and business cases to inform investments
  • Prepare presentations and recommendations for senior leadership
  • Hybrid role: work from home with in-person office/clinic/home visit needs

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • Analyzing MMR, MOR, MAO-004 files and medical claims
  • CMS data reconciliation and RAF leakage analysis
  • Building financial forecasts and business cases

KEY REQUIREMENTS

  • 4+ years of experience in risk adjustment analytics
  • 4+ years analyzing MMR, MOR, MAO-004 and medical claims data
  • 3+ actuarial exams passed
  • High proficiency with Microsoft Excel and SQL
  • Eligible to work in the US (no visa sponsorship available)

TECH STACK

  • Excel
  • Power_BI
  • Redshift
  • PowerPoint
  • Other_BI_Tool
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Role Summary

Loading...

HIGHLIGHTS

Senior health actuarial role focused on Medicare Advantage risk adjustment in Chicago. You’ll analyze CMS and claims data, reconcile RAF leakage, build financial models and business cases, and present findings to senior leadership. Requires 4+ years in risk adjustment and 3+ actuarial exams passed. Hybrid role with remote flexibility and in-person needs in Chicago.

JOB DESCRIPTION SUMMARY

  • Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
  • Analyze CMS datasets (MMR, MOR, MAO-004) and medical claims
  • Build scenarios, forecasts, and business cases to inform investments
  • Prepare presentations and recommendations for senior leadership
  • Hybrid role: work from home with in-person office/clinic/home visit needs

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • Analyzing MMR, MOR, MAO-004 files and medical claims
  • CMS data reconciliation and RAF leakage analysis
  • Building financial forecasts and business cases

KEY REQUIREMENTS

  • 4+ years of experience in risk adjustment analytics
  • 4+ years analyzing MMR, MOR, MAO-004 and medical claims data
  • 3+ actuarial exams passed
  • High proficiency with Microsoft Excel and SQL
  • Eligible to work in the US (no visa sponsorship available)

TECH STACK

  • Excel
  • Power_BI
  • Redshift
  • PowerPoint
  • Other_BI_Tool

Job Overview

Salary
$99k - $124k
Years of Experience
4+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a senior health actuary/analyst with 4+ years in Medicare Advantage risk adjustment, 3+ actuarial exams passed, strong SQL and Excel skills, and experience turning CMS data into financial insights.

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision InsuranceAnnual Bonus401(k) PlanPaid Parental LeavePaid Sick LeaveTraining BudgetWellness Program
Fresh Role
Premium Window
1d
1 days ago

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Job Overview

Salary
$99k - $124k
Years of Experience
4+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a senior health actuary/analyst with 4+ years in Medicare Advantage risk adjustment, 3+ actuarial exams passed, strong SQL and Excel skills, and experience turning CMS data into financial insights.

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision InsuranceAnnual Bonus401(k) PlanPaid Parental LeavePaid Sick LeaveTraining BudgetWellness Program
Fresh Role
Premium Window
1d
1 days ago

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Health/Other/IC Level
Strive Health

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health•Chicago, Illinois, United States•1d ago
HybridMedicare AdvantagePredictive Modelling & MLBusiness Intelligence & ReportingRegulatory Reporting

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