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Role Summary

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HIGHLIGHTS

Lead actuarial analyst role in Medicare Advantage Risk Adjustment at Strive Health, a kidney care-focused healthcare company. You'll analyze CMS data to evaluate RAF revenue, forecast financial impacts, and develop business cases to support operational and clinical strategy. This hybrid-remote role requires strong SQL skills and at least 3 actuarial exams passed. The company offers a formal Actuarial Study Program with exam support and bonuses.

JOB DESCRIPTION SUMMARY

  • Analyze RA performance data for revenue, payment accuracy, and ROI
  • Use SQL & Excel to model scenarios and forecast program impacts
  • Reconcile CMS submissions and RAF leakage end-to-end
  • Present financial insights to senior leadership

DOMAIN EXPERTISE

  • Medicare Advantage risk adjustment
  • CMS data analysis (MMR, MOR, MAO-004)
  • Medical claims data analysis

KEY REQUIREMENTS

  • 4+ years in risk adjustment analytics
  • 3+ actuarial exams passed
  • High proficiency in Microsoft Excel and SQL
  • Bachelor's degree in quantitative/health field
  • No visa sponsorship available

TECH STACK

  • Excel
  • Power_BI
  • Redshift
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Role Summary

Loading...

HIGHLIGHTS

Lead actuarial analyst role in Medicare Advantage Risk Adjustment at Strive Health, a kidney care-focused healthcare company. You'll analyze CMS data to evaluate RAF revenue, forecast financial impacts, and develop business cases to support operational and clinical strategy. This hybrid-remote role requires strong SQL skills and at least 3 actuarial exams passed. The company offers a formal Actuarial Study Program with exam support and bonuses.

JOB DESCRIPTION SUMMARY

  • Analyze RA performance data for revenue, payment accuracy, and ROI
  • Use SQL & Excel to model scenarios and forecast program impacts
  • Reconcile CMS submissions and RAF leakage end-to-end
  • Present financial insights to senior leadership

DOMAIN EXPERTISE

  • Medicare Advantage risk adjustment
  • CMS data analysis (MMR, MOR, MAO-004)
  • Medical claims data analysis

KEY REQUIREMENTS

  • 4+ years in risk adjustment analytics
  • 3+ actuarial exams passed
  • High proficiency in Microsoft Excel and SQL
  • Bachelor's degree in quantitative/health field
  • No visa sponsorship available

TECH STACK

  • Excel
  • Power_BI
  • Redshift

Job Overview

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

Ideal Candidate Profile

Ideal for a near-ASA/ACAS student or credentialed candidate with 4+ years in Medicare Advantage risk adjustment, strong SQL skills, and comfort translating CMS data into business cases and financial forecasts.

Benefits

Bonus EligibleAnnual Bonus401(k) PlanHealth InsuranceDental InsuranceVision InsuranceHybrid WorkPaid Parental LeaveStudy SupportTuition Reimbursement
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

Ideal for a near-ASA/ACAS student or credentialed candidate with 4+ years in Medicare Advantage risk adjustment, strong SQL skills, and comfort translating CMS data into business cases and financial forecasts.

Benefits

Bonus EligibleAnnual Bonus401(k) PlanHealth InsuranceDental InsuranceVision InsuranceHybrid WorkPaid Parental LeaveStudy SupportTuition Reimbursement
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."

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health

Health/Insurtech/IC Level
Strive Health

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health
United States•11h ago
FlexibleMedicare Advantage

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