Hybrid-Remote Lead Actuarial Analyst - Risk Adjustment

Strive Health Services LLC

Raleigh (NC)

Hybrid

USD 99,000 - 124,000

Full time

39 hours ago

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Benefits offered by this job

Hybrid-Remote Flexibility

Comprehensive Benefits

Financial & Retirement Support

Time Off & Leave

Wellness & Growth

Job summary

Strive Health seeks a Lead Actuarial Analyst, MA Risk Adjustment to join our high-performing, insights-driven team in Raleigh. You will translate risk adjustment data into financial insights, analyze CMS data, and influence strategic decisions across clinical and financial domains.

This role supports actuarial credential advancement through our study program. We offer a competitive salary, a 10% target bonus, comprehensive benefits, and a hybrid-remote work model designed to support work-life

Qualifications

Bachelor’s degree in a quantitative or health-related field is required.
3+ actuarial exams passed are required.
High proficiency in Excel and SQL is expected.
Experience with Power BI, Redshift, and dbt docs is a plus.

Responsibilities

Translate RA performance data into clear financial insights (revenue impact, payment accuracy, ROI, forecasting).
Analyze CMS data to identify opportunities to increase operational efficiency.
Interpret trends, model scenarios, and assess program and policy impacts.
Enable data-driven decisions by linking operational performance to enterprise financial outcomes.
Perform end-to-end reconciliation from submissions to CMS acceptance, RAF leakage, and implement controls.
Develop business cases to assess opportunity, metrics, and provide data-driven insights for investment decisions.
Prepare and deliver reports, presentations, and recommendations to senior leadership.