Actuarial Analyst (Medicaid Risk Adjustment) - REMOTE

Molina Healthcare; City of Rochester (NY); Remote; USD 77,000 - 142,000; Full time

Job summary

A healthcare provider in Rochester seeks a Subject Matter Expert for Medicaid risk adjustment programs. This role involves analyzing risk scores, calibrating models based on state programs, and leading actuarial studies. A Bachelor's degree in a relevant field and at least two actuarial exams are required. The position offers a competitive salary range and opportunities for professional growth.

Benefits

Competitive benefits and compensation package

Qualifications

• 1-2 years of relevant experience is required.
• Must have passed at least 2 actuarial exams.
• Preferred experience is 3-4 years.

Responsibilities

• Analyze risk score results and calculate financial impact.
• Calibrate risk adjustment models based on state programs.
• Develop and lead actuarial studies related to risk scores.

Skills

Risk analysis

Data synthesis

Actuarial studies

Education

Bachelor's Degree in Mathematics, Statistics, or Economics

Job description

Overview

JOB DESCRIPTION

Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources to identify risks. Additional leadership opportunities are 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 trends or other issues related to risk scores.
• Calibrate risk adjustment models based on state programs
• Develop and lead actuarial studies related to risk scores and present findings to leadership
• Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting
• 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

1-2 Years

Required License, Certification, Association

Must have passed at least 2 actuarial exams.

Preferred Experience

3-4 Years

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.

Pay Range: $77,969 - $141,371 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.