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Role Summary

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HIGHLIGHTS

Senior Health actuarial analyst focused on Medicare risk adjustment at Clover (remote-first). You will maintain CMS HCC/RxHCC models, support monthly close and revenue accruals, build automated tools and data pipelines, and deliver analyses for forecasting, pricing, and reserving. The role expects strong programming skills and actuarial exam progress and works closely with finance, data science, and operations.

JOB DESCRIPTION SUMMARY

  • Maintain CMS HCC and RxHCC models and develop member-level risk scores
  • Support monthly close and actuarial risk-adjusted revenue accruals
  • Build automated actuarial tools, data pipelines, and analytic dashboards
  • Collaborate with Data Science, Finance, Engineering, and Provider teams
  • Remote-first role with eligibility for Clover's Actuarial Student Program

DOMAIN EXPERTISE

  • Medicare Risk Adjustment and CMS HCC/RxHCC modeling
  • CMS EDS submissions and healthcare claims data
  • Actuarial risk-adjusted revenue accruals and monthly close
  • Forecasting, reserving, and trend analysis for health plans
  • Building automated actuarial tools and analytic dashboards

KEY REQUIREMENTS

  • Completed at least two actuarial exams
  • 2+ years experience with Medicare Risk Adjustment and CMS EDS submissions
  • 2+ years programming experience (SQL, R, Python, SAS, or VBA)
  • Experience working with healthcare claims and EDS data

TECH STACK

  • Excel
  • PowerPoint
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Role Summary

Loading...

HIGHLIGHTS

Senior Health actuarial analyst focused on Medicare risk adjustment at Clover (remote-first). You will maintain CMS HCC/RxHCC models, support monthly close and revenue accruals, build automated tools and data pipelines, and deliver analyses for forecasting, pricing, and reserving. The role expects strong programming skills and actuarial exam progress and works closely with finance, data science, and operations.

JOB DESCRIPTION SUMMARY

  • Maintain CMS HCC and RxHCC models and develop member-level risk scores
  • Support monthly close and actuarial risk-adjusted revenue accruals
  • Build automated actuarial tools, data pipelines, and analytic dashboards
  • Collaborate with Data Science, Finance, Engineering, and Provider teams
  • Remote-first role with eligibility for Clover's Actuarial Student Program

DOMAIN EXPERTISE

  • Medicare Risk Adjustment and CMS HCC/RxHCC modeling
  • CMS EDS submissions and healthcare claims data
  • Actuarial risk-adjusted revenue accruals and monthly close
  • Forecasting, reserving, and trend analysis for health plans
  • Building automated actuarial tools and analytic dashboards

KEY REQUIREMENTS

  • Completed at least two actuarial exams
  • 2+ years experience with Medicare Risk Adjustment and CMS EDS submissions
  • 2+ years programming experience (SQL, R, Python, SAS, or VBA)
  • Experience working with healthcare claims and EDS data

TECH STACK

  • Excel
  • PowerPoint

Job Overview

Salary
$108k - $132k
Years of Experience
2+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

A senior health actuarial analyst (Senior level) with Medicare Advantage experience, at least two actuarial exams passed, and strong SQL/R/Python skills who enjoys building automated pipelines and dashboards for risk adjustment and forecasting.

Benefits

Annual BonusEquity/Stock Options401(k) PlanHealth InsuranceDental InsuranceVision InsurancePaid Parental LeaveRemote FirstHome Office StipendMentorship 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
$108k - $132k
Years of Experience
2+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

A senior health actuarial analyst (Senior level) with Medicare Advantage experience, at least two actuarial exams passed, and strong SQL/R/Python skills who enjoys building automated pipelines and dashboards for risk adjustment and forecasting.

Benefits

Annual BonusEquity/Stock Options401(k) PlanHealth InsuranceDental InsuranceVision InsurancePaid Parental LeaveRemote FirstHome Office StipendMentorship 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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