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Role Summary

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HIGHLIGHTS

Senior health actuarial analytics role focused on Medicare Advantage risk adjustment based in Seattle (hybrid). You’ll analyze CMS data (MMR/MOR/MAO-004), reconcile submissions to CMS acceptance, model scenarios and forecast RAF impact, and present financial insights to senior leadership.

JOB DESCRIPTION SUMMARY

Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
Analyze MMR, MOR, MAO-004 and medical claims to identify revenue opportunities
Model scenarios and forecast payment accuracy and RAF impact
Hybrid role based in Seattle with study program and exam support
Requires 4+ years RA analytics experience and 3+ actuarial exams passed

DOMAIN EXPERTISE

Risk adjustment analytics
MMR, MOR, MAO-004 and medical claims analysis
Medicare Advantage risk adjustment
RAF leakage reconciliation

KEY REQUIREMENTS

4+ years of experience in risk adjustment analytics
3+ actuarial exams passed
Experience analyzing MMR, MOR, MAO-004 and medical claims
High proficiency in Microsoft Excel and SQL
Eligible to work in the US without sponsorship

TECH STACK

Excel
Power_BI
Redshift
Other_BI_Tool

Salary Pro Post a Job

Log in

Role Summary

Loading...

HIGHLIGHTS

Senior health actuarial analytics role focused on Medicare Advantage risk adjustment based in Seattle (hybrid). You’ll analyze CMS data (MMR/MOR/MAO-004), reconcile submissions to CMS acceptance, model scenarios and forecast RAF impact, and present financial insights to senior leadership.

JOB DESCRIPTION SUMMARY

Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
Analyze MMR, MOR, MAO-004 and medical claims to identify revenue opportunities
Model scenarios and forecast payment accuracy and RAF impact
Hybrid role based in Seattle with study program and exam support
Requires 4+ years RA analytics experience and 3+ actuarial exams passed

DOMAIN EXPERTISE

Risk adjustment analytics
MMR, MOR, MAO-004 and medical claims analysis
Medicare Advantage risk adjustment
RAF leakage reconciliation

KEY REQUIREMENTS

4+ years of experience in risk adjustment analytics
3+ actuarial exams passed
Experience analyzing MMR, MOR, MAO-004 and medical claims
High proficiency in Microsoft Excel and SQL
Eligible to work in the US without sponsorship

TECH STACK

Excel
Power_BI
Redshift
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 with 4+ years in Medicare Advantage risk adjustment, 3+ exams passed, strong SQL and Excel skills, and experience turning CMS data into financial insights and business cases.

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusStudy SupportExam Fees PaidExam BonusesPaid Parental Leave

Fresh Role

Premium Window

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Posted Today

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 with 4+ years in Medicare Advantage risk adjustment, 3+ exams passed, strong SQL and Excel skills, and experience turning CMS data into financial insights and business cases.

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusStudy SupportExam Fees PaidExam BonusesPaid Parental Leave

Fresh Role

Premium Window

0d

Posted Today

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

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health•Seattle, Washington, United States•2h ago

HybridMedicare AdvantageBusiness Intelligence & ReportingPredictive Modelling & MLRegulatory Reporting

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