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Role Summary

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HIGHLIGHTS

Senior health actuarial analyst focused on Medicare Advantage risk adjustment based in Washington, DC (hybrid). You will analyze CMS and claims data, reconcile RAF leakage, build forecasts and business cases, and present financial insights to senior leadership. Requires 4+ years in risk adjustment analytics and 3+ actuarial exams passed.

JOB DESCRIPTION SUMMARY

  • Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
  • Translate CMS performance data into revenue impact and forecasts
  • Build business cases and present recommendations to senior leadership
  • Hybrid role—work from home with in-person office, clinic, or patient visits
  • Requires 4+ years RA analytics experience and 3+ actuarial exams passed

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • MMR, MOR, MAO-004 and medical claims analysis
  • RAF leakage and CMS submissions reconciliation

KEY REQUIREMENTS

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

TECH STACK

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

Loading...

HIGHLIGHTS

Senior health actuarial analyst focused on Medicare Advantage risk adjustment based in Washington, DC (hybrid). You will analyze CMS and claims data, reconcile RAF leakage, build forecasts and business cases, and present financial insights to senior leadership. Requires 4+ years in risk adjustment analytics and 3+ actuarial exams passed.

JOB DESCRIPTION SUMMARY

  • Lead Medicare Advantage risk adjustment analytics and RAF reconciliation
  • Translate CMS performance data into revenue impact and forecasts
  • Build business cases and present recommendations to senior leadership
  • Hybrid role—work from home with in-person office, clinic, or patient visits
  • Requires 4+ years RA analytics experience and 3+ actuarial exams passed

DOMAIN EXPERTISE

  • Risk adjustment analytics
  • MMR, MOR, MAO-004 and medical claims analysis
  • RAF leakage and CMS submissions reconciliation

KEY REQUIREMENTS

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

TECH STACK

  • Excel
  • Power_BI
  • Redshift
  • PowerPoint
  • Other_BI_Tool
Health/Other/IC Level
Strive Health

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health•Washington, District of Columbia, United States•1d ago
HybridMedicare AdvantageBusiness Intelligence & ReportingRegulatory Reporting

Job Overview

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

Ideal Candidate Profile

Ideal for a senior health actuarial analyst with 4+ years in Medicare Advantage risk adjustment, 3+ actuarial exams passed, strong SQL and Excel skills, and experience reconciling CMS/RAF data while presenting insights to leadership.

Student

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusPaid 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 actuarial analyst with 4+ years in Medicare Advantage risk adjustment, 3+ actuarial exams passed, strong SQL and Excel skills, and experience reconciling CMS/RAF data while presenting insights to leadership.

Student

Benefits

Hybrid WorkHealth InsuranceDental InsuranceVision Insurance401(k) PlanAnnual BonusPaid 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."

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