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Role Summary

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HIGHLIGHTS

Lead actuarial analyst role focused on Medicare Advantage risk adjustment analytics in Seattle (hybrid). Own MA RA performance analysis, RAF reconciliation, forecasting, and present insights to senior leadership. Requires 4+ years RA analytics experience and 3+ actuarial exams passed.

JOB DESCRIPTION SUMMARY

  • Lead MA risk adjustment analytics and RAF reconciliation
  • Analyze CMS files (MMR, MOR, MAO-004) and medical claims
  • Forecast revenue impact and build business cases for investments
  • Hybrid-remote role based in Seattle with some in-person duties
  • Actuarial study program with exam fee support and rewards

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • MMR, MOR, MAO-004 and medical claims analysis
  • RAF leakage reconciliation and CMS submissions
  • Financial performance analysis and forecasting for MA programs

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 in Microsoft Excel and SQL
  • Authorized to work in the US without visa sponsorship

TECH STACK

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

Loading...

HIGHLIGHTS

Lead actuarial analyst role focused on Medicare Advantage risk adjustment analytics in Seattle (hybrid). Own MA RA performance analysis, RAF reconciliation, forecasting, and present insights to senior leadership. Requires 4+ years RA analytics experience and 3+ actuarial exams passed.

JOB DESCRIPTION SUMMARY

  • Lead MA risk adjustment analytics and RAF reconciliation
  • Analyze CMS files (MMR, MOR, MAO-004) and medical claims
  • Forecast revenue impact and build business cases for investments
  • Hybrid-remote role based in Seattle with some in-person duties
  • Actuarial study program with exam fee support and rewards

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • MMR, MOR, MAO-004 and medical claims analysis
  • RAF leakage reconciliation and CMS submissions
  • Financial performance analysis and forecasting for MA programs

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 in Microsoft Excel and SQL
  • Authorized to work in the US without visa sponsorship

TECH STACK

  • Excel
  • Power_BI
  • Redshift
  • Other_BI_Tool
  • PowerPoint

Job Overview

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

Ideal Candidate Profile

A senior health actuarial analyst with 4+ years in Medicare Advantage risk adjustment, 3+ exams passed, strong SQL and Excel skills, and experience reconciling CMS files and RAF leakage.

Student

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusStudy Program FormalExam Fees CoveredExam 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."

Job Overview

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

Ideal Candidate Profile

A senior health actuarial analyst with 4+ years in Medicare Advantage risk adjustment, 3+ exams passed, strong SQL and Excel skills, and experience reconciling CMS files and RAF leakage.

Student

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusStudy Program FormalExam Fees CoveredExam 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
Strive Health Services LLC

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health Services LLC•Seattle, Washington, United States•1h ago
HybridMedicare AdvantageBusiness Intelligence & ReportingUW Support & Portfolio Management

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