Sr. Actuarial Analyst - Risk Adjustment
$70.1k - $126.2kCentene Corporation
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
$60k - $75k
...per Medicare beneficiary. We are seeking a highly motivated and detail-oriented individual to join our team as a Certified Risk Adjustment Coding Specialist . The primary responsibility of this role is to conduct thorough patient chart reviews to identify opportunities...RiskFull timeTemporary workPart timeWork at officeRemote workFlexible hoursWeekend workAfternoon shiftWeekday work$110k - $150k
...Reinsurance Actuarial Senior Analyst and or Associate Director Location: New York City, Chicago IL... ...Analyze the costs and benefits of risk transferred under reinsurance agreements... ...with market data. The salary may also be adjusted based on applicant’s geographic location...SeniorRiskFull timeTemporary workPart timeLocal areaRemote work$102.7k - $164.6k
...-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan... ...both Highmark and Highmark Health), including CFO, EVP, Chief Actuary, and Vice President, on project status including program...RiskFull timeFor contractorsWork at officeLocal area$107.7k - $199.3k
...Purpose: Conduct analysis, pricing, and risk assessment to estimate financial... ...Analytics Team in ensuring VBC contracts are actuarially sound and provide financial value. Key... ...office work schedules. Actual pay will be adjusted based on an individual's skills, experience...RiskFull timePart timeWork at officeRemote workFlexible hours$88.8k - $152.3k
...member feels valued. The Sr Actuarial Associate independently performs... ...forecasting, valuation, and risk management decisions. This... ...for less experienced analysts. Key Accountabilities... ...Recommend data-supported adjustments based on observed experience...SeniorRiskWork experience placementWork at office3 days per week$107.7k - $199.3k
...Position Purpose: Conduct analysis, pricing and risk assessment to estimate financial outcomes. Support the Actuarial Valuation Team through experience and trend... ...field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience,...RiskFull timePart timeWork at officeRemote workFlexible hours- ...Risk Adjustment Coding Analyst Senior HealthPartners is hiring a Risk Adjustment Coding Analyst Senior. This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based...SeniorRiskRemote job
$87.7k - $157.8k
...support tools to aid in planning processes and assessing risk to estimate financial outcomes. Manage actuarial needs and produce actuarial reports to aid in... ...field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education...RiskFull timePart timeWork at officeRemote workFlexible hours$90.5k - $155.2k
...service is the norm and every member feels valued. The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual contributor... ...analytical resource to cross-functional partners including actuarial, finance, clinical, and operational teams. The role requires...RiskWork experience placementWork at office3 days per week- ...involves assessing liability/compensability, evaluating losses, and adjusting assigned claims. In addition, the role involves interacting... ...counsel. Collaborate with internal medical, legal, and risk management resources to ensure optimal claim outcomes. Identify...SeniorRiskWork at officeLocal areaRemote workFlexible hours
$50k - $75k
...As a leading provider of crop insurance and other agricultural risk management tools, we recognize that our success is derived directly... ...? AgriSompo has a unique opportunity for a Crop Insurance Adjuster to join our Upper Midwest team , supporting our Multi-Peril...RiskFull timeWork at officeRemote workWorldwideHome officeFlexible hoursWeekend work$115.4k - $197.8k
...analytical thought partner to Population Health & Quality leadership, providing independent analytical expertise across Quality and Risk Adjustment. Combines deep healthcare performance knowledge with advanced hands-on analytical capabilities to independently access,...SeniorRiskWork experience placementWork at office3 days per week- ...ready to make a difference join us. The Impact Youll Have Blue Cross and Blue Shield of Minnesota is hiring a Program Manager Risk Adjustment Coding and this position youll be responsible for the design implementation evaluation and ongoing management of the Risk...RiskFull timeFor contractorsWork at officeRemote work2 days per week
$99.7k - $209.7k
...About the Business LexisNexis Risk Solutions is the essential partner in the assessment... ...Risk at About the Role: The Sr Statistical Modeler develops and implements... ...other need that requires accommodation or adjustment, please let us know by completing our Applicant...SeniorRiskFull timeLocal area$85.06k - $104.37k
...Range USD $85,064.00 - USD $104,373.00 /Yr. STAR Bonus % (At Risk Maximum) 7.50 - Salaried Non-Management except pharmacists... ...Wisconsin Overview Lumicera Health Services is seeking a Sr. Analyst, Health System Pharmacy Financial Performance to join our team!...SeniorRiskFull timeWork experience placementRemote workFlexible hours- ...responses to stimulation and automatically adjusts therapy based on real‑time... ...Reporting to the Director of Quality, the Sr. Supplier Quality Engineer is responsible... ...supplier performance, continuous improvement, risk reduction, and compliance throughout the product...SeniorRiskContract work
$100k - $135k
...Senior IT SOX Analyst + 10% Bonus That Consistently Pays Above Target + Profit Sharing + Flexible Hours + High Growth This Jobot Job... ...needs to be brought up to speed on SOX, which makes our IT SOX Risk & Compliance team central to how we scale responsibly. Why join...SeniorRiskLocal areaFlexible hours$82.7k - $110.3k
...continued innovation, we create mattresses with adjustable firmness, pressure relief, and... ...experienced Senior Supplier Quality Engineer (Sr.SQE) to lead supplier quality performance... ...responsible for supplier development, risk management, quality improvement, audit execution...SeniorRiskWork at officeNight shift3 days per week- ...functional team that includes product managers, analysts, engineers, clinical experts, and... ..., value-based care, and health risk, with the ability to apply these concepts... ...concepts, including measure construction, risk adjustment principles, stratification, and interpretation...SeniorRiskWork experience placementWork at officeLocal area
- ...contingency log, and reconcile remaining contingency to residual risk exposure. " Perform cost variance analysis, explain drivers,... ...exposure to cost contingency and schedule reserve; recommend adjustments as the risk profile changes. " Track and follow up on mitigation...SeniorRiskFor contractors
- ...Senior Health Actuarial RoleSenior Health actuarial role on Optum Health's reserving and forecasting team, supporting Medicare Advantage business in Eden Prairie, Minnesota, with remote work available across the U.S. You'll build and maintain reserving models, forecast...SeniorWork at officeRemote work
$75k - $90k
...Workplaces in Financial Services & Insurance Sr. Pricing Analyst PRIMARY PURPOSE OF THE ROLE: To... .... Sedgwick is the world’s leading risk and claims administration partner,... ...solutions in claims administration, loss adjusting, benefits administration, and product recall...SeniorRiskTemporary workLocal areaRemote workFlexible hours$76k - $141.1k
## Sr. Financial AnalystApply: On-site: Blaine, MN, US: Full time: Posted Today: R23519We’re looking for people who put their innovation... ...quality forecasts with a detailed understanding of potential risks and opportunities, including maintaining a working forecasting model...SeniorRiskMinimum wageFull timeTemporary workWork at officeLocal areaWorldwideFlexible hours$130k
...positive client relationships. · Develop strategies for aged, complex, or sensitive receivables. · Proactively identify collection risks and opportunities for improvement. · Provide leadership with insight into collection activity, trends, and anticipated cash...SeniorRiskFull timeFlexible hours$93.5k - $187k
...specialists provide comprehensive services including actuarial and financial, clinical and behavioral health, pharmacy, policy, and more. Sr. Government Health Actuary We will count on... ...of Marsh (NYSE: MRSH), a global leader in risk, reinsurance and capital, people and...SeniorRiskMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours3 days per week1 day per week$110.95k - $163.2k
...Sentara is hiring for an Epic Healthy Planet Senior IT Specialty Analyst! This is a fully remote position! Overview Responsible for... ...Familiarity with CMS quality programs, HEDIS measures, and risk adjustment. 5 to 7 years of relevant experience (Required) We provide...SeniorRiskFull timeTemporary workRemote workShift work- ...incorporate feedback from stakeholders and end‑users into the backlog; adjust as necessary. Requirements & Customer Experience (UX) User... ..., and support user acceptance testing. Planning, Delivery & Risk Sprint Planning: Participate in sprint planning to select stories...SeniorRiskWork experience placementLocal area
$72.8k - $130k
...help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Actuarial Analyst will be a vital contributor to the Optum Health reserving and forecasting team, focused on supporting Optum Care monthly reserving...SeniorMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work- ...\n Assist in budget development, manage to goals, and make adjustments as needed. \n Ensure departments meet or exceed performance... ...equipment, and physical security. \n Conduct Asset Protection Risk Analysis and complete Capital Projects as needed. \n Review...SeniorRiskWork experience placementLocal area
$206k - $220k
...performance, inventory health, shipping targets, and gross-to-net. Provides executive leadership with clear insight into performance, risk, and opportunity. Leads cross-functional go-to-market planning with Product, Merchandising, Marketing, Planning, Finance,...SeniorRiskFull timeSeasonal workRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Sr. Actuarial Analyst - Risk Adjustment. Be the first to apply!




