Sr. Actuarial Analyst - Risk Adjustment

Acturhire; United States; Remote; USD 70,000 - 126,000; Full time

Job summary

Centene is seeking an actuarial professional to support risk adjustment initiatives through data analysis, modeling, and validation. The role emphasizes data completeness, accuracy, and collaboration with cross-functional teams, including market-facing responsibilities.

The position is part of Centene's Actuarial Development Program, offering exam support and professional development. Full remote work within the continental US is preferred, with ET/CT time zones considered.

Qualifications

• Bachelor's degree in a related field or equivalent experience.
• Progress toward actuarial credential via successful exams (Rule of 5).
• Experience in data validation, manipulation, and quality assurance preferred.

Responsibilities

• Run and analyze market-level results using CDPS+Rx or similar risk adjustment models.
• Act as the team’s point of contact for an assigned group of markets.
• Apply knowledge of mathematics, probability, statistics, finance, and business to calculate financial outcomes.
• Develop and run data reports.
• Identify data issues and communicate insights to support business decisions.

Skills

Actuarial experience

SQL

Data analytics

SAS

Snowflake

Coding

Education

Bachelor's degree in related field

Tools

SAS

Snowflake

SQL

Job description

Position Purpose:

Support risk adjustment initiatives through data analysis, modeling, actuarial reporting, and data validation. Assist in financial analysis, data validation, and risk assessment to estimate outcomes.

Key Details:

This is a non-traditional actuarial role within operations, offering opportunities to build technical, analytical, and business skills while gaining exposure to business leaders and cross-functional teams. The role supports risk adjustment initiatives including data submissions, rate reconciliation, audits, and chart chase programs, with a focus on data completeness and accuracy. Candidates are required to have actuarial experience and demonstrated progress toward an actuarial credential through successful completion of actuarial exams. This role is part of Centene's Actuarial Development Program, offering exam support and professional development opportunities. Experience with data validation, manipulation, and quality assurance is preferred, along with strong SQL, coding, and data analytics skills working with large datasets. Experience with risk adjustment models, SAS, Snowflake, healthcare data, and process automation is highly desirable. The role includes identifying data issues, uncovering meaningful insights, and communicating findings to support business decisions. Fully remote within the continental U.S., with ET and CT time zones preferred.

• Run and analyze market-level results using CDPS+Rx or similar risk adjustment models.
• Act as the team’s point of contact for an assigned group of markets.
• Apply knowledge of mathematics, probability, statistics, finance, and business to calculate financial outcomes.
• Assist with developing probability tables based on analysis of statistical data and other pertinent information.
• Analyze and evaluate required premium rates.
• Develop and run data reports.
• Perform other duties as assigned and comply with all policies and standards.

Education/Experience:

Bachelor's degree in a related field or equivalent experience. Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.

License/Certification:

Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.

Pay Range: $70,100 - $126,200 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day.

You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act