Lead Actuarial Analyst, MA Risk Adjustment
$99k - $124kStrive Health Services LLC
How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! 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, plus health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources. Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves. Wellness & Growth – Family forming services through Maven Maternity at no cost and 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. You will play a critical role in evaluating financial performance, uncovering areas of opportunity, and use 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 position is internally titled Lead Analyst, Risk Adjustment Analytics). 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 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 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% Final compensation will be determined based on location, experience, and qualifications. 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 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. We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means. #J-18808-Ljbffr Strive Health Services LLC
$86.4k - $138.6k
A leading healthcare provider in Raleigh, North Carolina, is seeking a Manager for Risk Adjustment. This role involves managing staff, ensuring compliance with coding guidelines, and improving quality measures. A Bachelor’s degree in a health-related field and significant...RiskRemote job$104k - $130k
...outcome. Bonus points if: Experience working in the healthcare industry Experience and familiarity with MA, ACA and Medicaid Risk Adjustment models. Experience with other business intelligence backend and analytics applications Familiarity with or interest...RiskWork experience placementRemote work$104k - $130k
...positive outcome. Bonus Points If Experience working in the healthcare industry Experience and familiarity with MA, ACA and Medicaid Risk Adjustment models. Experience with other business intelligence backend and analytics applications Familiarity with or interest...RiskWork experience placement- ...analytics tools like Excel and Power BI is essential. This position supports hybrid work with some travel to provider offices required. A strong knowledge of Risk Adjustment and coding guidelines is necessary, along with excellent communication skills. #J-18808-Ljbffr...RiskRemote work
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- ...option possible. The Senior Actuarial Analyst is responsible for developing... ...be expected to independently lead projects from start to finish... ...Ability to adapt to change and adjust priorities quickly, as... ...Minimum of Bachelor’s degree in risk management, finance, economics...RiskPermanent employmentWork experience placementRemote workFlexible hours
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Lead Account Technology Strategist (ATS) The Lead Account Technology... ...on new features, and adjust strategies as needs and goals change... ...diverse tasks, objectives, and risks. Excellent oral and written communication... ...Azure Certified (CC‑VAD‑MA) or Virtual Apps and Desktops Service...RiskLocal areaImmediate startRemote work$15k
A leading risk and claims management firm is seeking a Desk Adjuster to manage claims up to $15,000. The ideal candidate will possess a Bachelor's degree and have strong analytical and negotiating skills. Responsibilities include evaluating insurance policies, conducting...RiskHourly pay$81.07k - $129.71k
Job Description Join our team as an Actuarial Analyst, where you will use your expertise in mathematics, probability, statistics, and business... .... Executes control activities to support Enterprise Risk Management. Provides analytic support for corporate and departmental...Risk$81.07k - $129.71k
Job Description We are seeking a motivated Actuarial Analyst to join our Medicare Pricing Team. In this role, you will apply your mathematical... .... Executes control activities to support Enterprise Risk Management. Provides analytic support for corporate and departmental...Risk$113k - $190k
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...Become a part of our caring community The Business Intelligence Lead solves complex business problems using data from internal and... ...experiences. ~ You must have experience with Medicare Risk Adjustment (MRA), Health Information Exchange (HIE), and quality healthcare...RiskFull timeTemporary workRemote work$104k - $130k
A data analytics company in Raleigh, NC is seeking a skilled individual to work closely with internal partners in analyzing client data and generating reports. The ideal candidate will hold a Bachelor's degree and have hands-on experience with business intelligence tools...Risk- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops,...RiskFull timePart timeSeasonal work
$89k - $121.4k
...Professional in Raleigh, North Carolina. In this role, you'll manage complex data and influence business strategies related to Medicare risk adjustment, utilizing advanced skills in SQL and financial modeling. The position involves collaborating with stakeholders and providing...RiskFull time- Capterra Risk Solutions is seeking a Sr. Captive Account Executive to deliver captive management and advisory services to clients. This role blends underwriting, risk management, and relationship leadership expertise while coordinating between internal teams and external...RiskRemote job
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$40 - $60 per hour
...NC area is seeking a QC Sample Management Lead to design, implement, and oversee the end... ...testing timelines Identify risks to turnaround time and proactively implement... ...accommodation, such as the modification or adjustment of the job application process or interviewing...RiskContract workTemporary work- ...applications. The role requires an active Secret security clearance and 5+ years of experience in information networks, with proficiency in Risk Management Framework tools like eMASS. Key responsibilities include coordinating security efforts, monitoring compliance, and...Risk
- SECU in North Carolina is looking for an experienced audit professional to lead internal audit assurance activities. The role demands strong leadership in audit programs, risk management, and collaboration with team members to ensure compliance and governance. Applicants...RiskRemote job
$72.91k - $95k
...Financial Services & Insurance Claims Team Lead - Workers Compensation PRIMARY PURPOSE:... ...other roles. Sedgwick is the world’s leading risk and claims administration partner, which... ...solutions in claims administration, loss adjusting, benefits administration, and product...RiskContract workWork at officeLocal areaFlexible hours$80k - $85k
...common goal. The Role The Partner Admissions Lead (PAL) is the operational leader of a... ...Manager of Admissions Services. Identify at‑risk students using the Risk Rating Assessment... ...coaching strategies and operational adjustments that improve conversion and student progression...RiskLocal areaRemote workMonday to FridayFlexible hoursWeekend workAfternoon shift- ...Installat searching for new experiences? As a leading Trane® independent office, Brady brings... ...vision, depth perception, and ability to adjust focus. This position requires working... ...particles; outside weather conditions; risk of electrical shock (high voltage); and...RiskTemporary workWork at officeLocal areaRelocation packageMonday to FridayNight shiftWeekend work
$110.2k - $151.5k
Lead Customs Specialist, US Department: Operations Employment Type: Full Time Location... .... Escalate recurring issues, systemic risks, or potential compliance concerns to the... ...location, the base salary range will be adjusted geographically. For Field Sales roles, the...RiskHourly payFull timeTemporary workLocal areaFlexible hours- ...Specialist to rigorously evaluate and enforce compliance with corporate quality standards and regulatory requirements. The role involves leading Quality Management System reviews, managing deviations, and executing data integrity assessments. The ideal candidate should...Risk
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