Senior Actuarial Analyst (Medicare Risk Adjustment) - REMOTE

Molina Healthcare; Cleveland (OH); Remote; USD 77,000 - 140,000; Full time

Job summary

A healthcare organization in Cleveland is seeking a professional to manage Medicare risk adjustment estimates and premium rates. This role involves data analysis, model maintenance, and collaboration with Actuarial staff to enhance risk assessment. The ideal candidate will have a Bachelor's degree in a relevant field and experience in actuarial practices. A competitive compensation package is offered.

Benefits

Competitive benefits

Equal Opportunity Employer

Qualifications

• 2-4 years of experience in a related field.
• Must have passed at least 3 actuarial exams.
• 5-6 years of preferred experience.
• ASA or near ASA preferred.

Responsibilities

• Calculate risk adjustment payment estimates with Actuarial staff.
• Identify trends related to risk scores.
• Maintain risk score models for accuracy.
• Generate reports for risk adjustment calculations.

Skills

Data analysis

Collaboration with Actuarial staff

Model design and maintenance

Financial reporting

Communication of results

Forecast preparation

Education

Bachelor's Degree in Mathematics, Statistics, or Economics

Tools

SQL

Job description

JOB DESCRIPTION

Job Summary

Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact.

KNOWLEDGE/SKILLS/ABILITIES

• Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions.
• Analyze results to identify early signs of trends or other issues related to risk scores.
• Design and maintain risk score models.
• Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting.
• Extract and compile information from various systems to support executive decision-making.
• Research and develop reports and analysis for senior management; effectively communicate results.
• Assist in the preparation of forecasts/bids/filings related to risk adjustment.

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

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $140,000 / ANNUAL

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