Senior Actuarial Analyst (Medicaid Risk Adjustment)- REMOTE

Molina Healthcare; Macon (GA); Remote; USD 77,000 - 172,000; Full time

Job summary

A leading healthcare provider is seeking a Subject Matter Expert for Medicaid risk adjustment programs. This role involves analyzing and maintaining risk models, developing actuarial studies, and identifying improvement opportunities. The ideal candidate should have a Bachelor's in Mathematics or similar, relevant experience, and a strong willingness to lead initiatives. A competitive compensation package is offered, ranging from $77,969 to $171,058 annually.

Benefits

Competitive benefits and compensation package

Equal Opportunity Employer

Qualifications

• 2-4 years of relevant experience.
• Must have passed at least 3 actuarial exams.
• Preferred 5-6 years of experience in related fields.

Responsibilities

• Responsible for being the SME for Medicaid risk adjustment programs.
• Maintain risk adjustment model and estimate risk scores.
• Analyze impact and extract data to identify risks.

Skills

Analyze risk score results

Calibrate risk adjustment models

Develop actuarial studies

Generate and distribute reports

Identify opportunities for improvement

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.