JOB DESCRIPTION
Job Summary
Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintains the risk adjustment model, identifies risks, and estimates risk scores and financial impact. Additional leadership opportunity is available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required.
KNOWLEDGE/SKILLS/ABILITIES
- Analyze risk score results - calculate financial impact and identify drivers
- Calibrate risk adjustment models based on state programs
- Develop and lead actuarial studies related to risk scores and present findings to leadership.
- Generate and present risk score reporting to support operations
- Identify opportunities for improvement in risk adjustment programs and develop advocacy accordingly
JOB QUALIFICATIONS
Required Education
- Bachelor's Degree in Mathematics, Statistics, or Economics
Required Experience
- 2-4 Years
Required License, Certification, Association
- Must have passed at least 3 actuarial exams.
Preferred Experience
- 5-6 Years of actuarial experience
- SQL or other programming proficiency
- Strong verbal and written communication skills
Preferred License, Certification, Association
- ASA or near ASA
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Working at
Molina Healthcare
Molina Healthcare is a leading managed healthcare company dedicated to providing quality healthcare services to underserved communities. With a strong commitment to improving access to care, Molina Healthcare offers a wide range of health insurance plans and solutions. As an actuary at Molina Healthcare, you'll play a crucial role in assessing and managing risks to ensure the financial stability of the company's healthcare offerings. Actuaries at Molina Healthcare utilize their expertise in statistical analysis and risk assessment to develop pricing strategies, analyze healthcare trends, and provide insights that support evidence-based decision-making. Molina Healthcare's focus on serving vulnerable populations and providing cost-effective care creates unique challenges and opportunities for actuaries. Collaborating with cross-functional teams, actuaries at Molina Healthcare analyze complex healthcare data, identify trends, and develop innovative solutions that improve health outcomes while managing costs. Professional growth is highly valued at Molina Healthcare, and actuaries have access to ongoing training and development opportunities. Actuaries can enhance their skills and expertise while contributing to the company's mission of providing quality healthcare to those who need it most. Join Molina Healthcare's esteemed actuarial team and embark on a fulfilling career where you can make a meaningful impact on underserved communities, drive healthcare innovation, and enjoy a supportive work environment.