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Lead Actuarial Analyst, MA Risk Adjustment

$99k - $124k

Strive Health

How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk early, coordinating thoughtful care, and supporting people through every stage of their health journey. Benefits & Perks 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, and health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance‑based 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 leaves. Wellness & Growth – Family‑forming services through Maven Maternity at no cost, physical wellness perks, mental health support, and an annual professional development stipend. To learn more about our offerings, click here. What You’ll Do We are seeking a Lead Actuarial Analyst, MA Risk Adjustment to join our high‑performing, insights‑driven team. Your role will involve evaluating financial performance, uncovering opportunities, and using your actuarial exam progress to translate complex data into actionable strategies that directly influence how Strive supports patients, clinicians, and markets in achieving both clinical and financial success. Essential Functions Translate RA performance data into clear financial insights (e.g., 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 (e.g., staffing, tech). 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 a 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. 3+ actuarial exams passed. High proficiency in Microsoft Excel and SQL. Experience with Power BI, Amazon Redshift, and dbt docs is a plus. Bachelor’s degree in a quantitative or health‑related field (e.g., Economics, Public Health, Statistics, Health Services Research, Mathematics, Finance). Annual Salary Range: $99,000 – $124,000. This position is also eligible for a target annual bonus of 10%. Final compensation will be determined based on location, experience, and qualifications. Strive Health is an equal‑opportunity employer and a 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 qualifications. If you require a 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. We do not accept unsolicited resumes from outside recruiters or placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means. #J-18808-Ljbffr Strive Health

Vacancy posted 1 day ago
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