Lead Actuarial Analyst, Risk Adjustment (Hybrid-Remote)
Strive Health Services LLC
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Benefits offered by this job
Job summary
Strive Health Services LLC is seeking a Lead Actuarial Analyst to join a high-performing team focused on risk adjustment analytics and financial performance. You will translate data into actionable insights, evaluate CMS data, and model scenarios to guide strategic decisions across clinical and financial domains.
Ideal candidates have 4+ years in risk adjustment analytics, actuarial exams, and strong Excel/SQL skills, with PBI/Redshift/dbt as pluses.
Qualifications
- 4+ years in risk adjustment analytics.
- 4+ years analyzing MMR, MOR, MAO-004 and medical claims data.
- 3+ actuarial exams passed.
- Proficient in Excel and SQL.
- Experience with PBI, Redshift, dbt docs is a plus.
- Bachelor’s degree in quantitative/health field.
Responsibilities
- Translate RA performance data into financial insights.
- Analyze CMS data to identify efficiency opportunities.
- Interpret trends, model scenarios, and assess program impacts.
- Link operational performance to enterprise financial outcomes.
- Perform end-to-end reconciliation from submissions to CMS acceptance and RAF leakage.
- Develop business cases and target metrics for investments.
- Prepare and deliver reports to senior leadership.
Skills
Education
Tools
Job description
Strive Health Services LLC is seeking a Lead Actuarial Analyst to join a high-performing team focused on risk adjustment analytics and financial performance. You will translate data into actionable insights, evaluate CMS data, and model scenarios to guide strategic decisions across clinical and financial domains.
Ideal candidates have 4+ years in risk adjustment analytics, actuarial exams, and strong Excel/SQL skills, with PBI/Redshift/dbt as pluses.
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