Senior Actuarial Analyst (Medicaid Risk Adjustment)- REMOTE

Molina Healthcare; Cleveland (OH); Remote; USD 77,000 - 172,000; Full time

Job summary

A leading healthcare company in Cleveland, Ohio is seeking a Subject Matter Expert (SME) for Medicaid risk adjustment programs. This role involves analyzing risk score results, developing actuarial studies, and enhancing risk adjustment programs. Candidates should possess a Bachelor's in Mathematics or Economics and have passed at least 3 actuarial exams. Competitive compensation offered within a range of $77,969 to $171,058 annually.

Qualifications

• 2-4 years of relevant experience in Medicaid risk adjustment.
• Must have passed at least 3 actuarial exams.
• Preferred 5-6 years of experience with ASA certification.

Responsibilities

• Lead the analysis of Medicaid risk adjustment programs.
• Develop reports to support financial reporting for risk adjustments.
• Identify and implement improvements in risk programs.

Skills

Analyze risk score results

Calibrate risk adjustment models

Develop actuarial studies

Generate routine reports

Identify improvement opportunities

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 — 2-4 Years
• Required License, Certification, Association — Must have passed at least 3 actuarial exams.
• Preferred Experience — 5-6 Years
• 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.

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Pay Range: $77,969 - $171,058 / ANNUAL

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