Lead Actuarial Analyst, MA Risk Adjustment

What We Strive For At Strive Health, we’re driven by a purpose: transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care, we significantly improve outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization. Our high‑touch care model integrates with local providers and uses predictive data to identify and support at‑risk patients along their entire care journey. We embrace diversity, celebrate successes, and support each other, making Strive the destination for top talent in healthcare. Join us in making a real difference. Benefits & Flexibility Hybrid‑Remote Flexibility – Work from home while fulfilling in‑person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer‑paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance‑based discretionary bonus program, 401(k) with employer match, and financial wellness resources. Time Off & Leave – Paid holidays, vacation time, sick time, and paid [birth]giving, bonding, sabbatical, and living donor leave. Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend. What You’ll Do We are seeking a Lead Actuarial Analyst, MA Risk Adjustment to join our high‑performing, insights‑driven team. You will play a critical role in evaluating financial performance, uncovering areas of opportunity, and using your 3+ actuarial exam progress to help translate complex data into actionable strategies. Your work will directly influence how Strive supports patients, clinicians, and markets in achieving both clinical and financial success. This individual will work on a hybrid basis with 2‑3 days each week in our Denver HQ. Essential Functions Translate RA performance data into clear financial insights (i.e., revenue impact, payment accuracy, ROI, forecasting). Analyze CMS data to identify areas of opportunity to increase operational efficiency. Interpret trends, model scenarios, and assess program and policy impacts. Enable data‑driven decisions by linking operational performance to enterprise financial outcomes. Perform end‑to‑end reconciliation from submissions to CMS acceptance, RAF leakage, and implement controls. Develop business cases to assess opportunity, determine target metrics, and provide data‑driven insights to support investment decisions (i.e., staffing, tech, etc.). Prepare and deliver clear and concise reports, presentations, and recommendations to senior leadership, illustrating the findings and implications of analyses conducted. Who You Are A highly analytical problem‑solver with strong sense of ownership and intellectual curiosity. Able to manage a high volume of recurring and ad‑hoc deliverables without compromising quality. Comfortable navigating ambiguity and bringing structure to complex problems. An exceptional communicator who can translate technical findings into actionable business recommendations. Qualifications 4+ years of experience in risk adjustment analytics. 4+ years of experience analyzing MMR, MOR, MAO‑004 and medical claims data. High degree of proficiency in Microsoft Excel and SQL. Experience with PBI, Redshift, dbt docs is a plus. Bachelor’s degree in a quantitative or health‑related field (e.g., Economics, Public Health, Statistics, Health Services Research, Math, Finance). Annual Salary Range: $99,000 - $124,000. This position is also eligible for a target annual bonus of 10%. Strive Health is an equal opportunity employer and drug‑free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all the qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre‑employment testing, or otherwise participating in the employee selection process, please direct your inquiries to View email address on click.appcast.io. #J-18808-Ljbffr