Risk Adjustment Analytics Lead

Strive Health Services LLC; Seattle (WA); Hybrid; USD 99,000 - 124,000; Full time

Benefits offered by this job

Hybrid-Remote Flexibility

Health insurance (medical, dental, and

Job summary

Strive Health seeks a Lead Actuarial Analyst, MA Risk Adjustment to join a high-performing, insights-driven team. You will evaluate financial performance, uncover opportunities, and translate complex data into actionable strategies.

The role offers an actuarial study program with exam support and credentials rewards. You’ll work on translating RA data into financial insights, analyze CMS data, and develop business cases to drive investment decisions, with a focus on improving both clinical and

Qualifications

• 4+ years of experience in risk adjustment analytics.
• 4+ years of experience analyzing MMR, MOR, MAO-004 and medical claims data.
• 3+ actuarial exams passed.
• High degree of proficiency in Microsoft Excel and SQL.
• Experience with Power BI, Redshift, dbt docs is a plus.
• Bachelor’s degree in a quantitative or health-related field (Economics, Public Health, Statistics, etc.).

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 and determine target metrics for investments.

Skills

Risk adjustment analytics

Excel

SQL

Communication

Education

Bachelor’s degree in a quantitative or health-related field

Tools

Power BI

Redshift

dbt docs

Job description

Strive Health seeks a Lead Actuarial Analyst, MA Risk Adjustment to join a high-performing, insights-driven team. You will evaluate financial performance, uncover opportunities, and translate complex data into actionable strategies.

The role offers an actuarial study program with exam support and credentials rewards. You’ll work on translating RA data into financial insights, analyze CMS data, and develop business cases to drive investment decisions, with a focus on improving both clinical and