Lead Actuarial Analyst, MA Risk Adjustment
$99k - $124kStrive 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 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
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). We offer a competitive Actuarial Study Program designed to help you succeed, including exam fee support, study resources, and rewards for passing exams and achieving actuarial credentials. Essential Functions
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.
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.
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). We offer a competitive Actuarial Study Program designed to help you succeed, including exam fee support, study resources, and rewards for passing exams and achieving actuarial credentials. 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.
- 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.
- 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).
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.
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Lead Actuarial Analyst, MA Risk Adjustment in Raleigh, NC vacancy
- Strive Health, LLC is looking for a Lead Actuarial Analyst in Raleigh, NC to evaluate financial performance and guide data-driven operational... .... The role requires 4+ years of experience in risk adjustment analytics along with strong skills in SQL and Excel. You’...RiskRemote job
$143.62k - $229.79k
Blue Cross and Blue Shield of North Carolina is seeking a Consulting Actuary - ACA Risk Adjustment to deliver key actuarial services and insights, managing pricing strategies and evaluating care management models. Ideal candidates will have 7+ years of experience and be...Risk$143.62k - $229.79k
Job Description As a Consulting Actuary - ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business...Risk$117.2k - $222.5k
Job Description As a Consulting Actuary at our healthcare organization... ...actuarial expertise. You'll lead initiatives that directly impact... ...and identify emerging risks and opportunities in a rapidly... ...Experience in Medicare Advantage Risk Adjustment highly preferred. What You’ll...Risk$89.17k - $142.68k
Blue Cross and Blue Shield of North Carolina is seeking a Senior Data Analyst with expertise in Affordable Care Act Risk Adjustment. The candidate will collaborate with stakeholders to ensure the accuracy of EDGE data submissions. This role requires strong analytical skills...RiskRemote job- ...scale peril events, enhancing underwriting judgment and overall risk insights. Conduct model performance assessments by developing... ...senior stakeholders. Advance modeling capabilities by applying actuarial techniques to build and enhance cyber, man-made accumulation,...Risk
$84.63k - $112.84k
...connectivity, join us today. The Role As a Lead Finance Analyst - Global Partner Solutions (GPS), you... ...of financial results. Identify risks and opportunities across the business and... ...,122 in these states: AK CA CT DC DE IL MA MD NJ NY TX VA WA Lumen offers a...RiskTemporary workRemote work$169.4k - $279.6k
...way for best-in-class solutions. As a Lead Architect, you will collaborate with senior... ...AI design • Help establish governance, risk, and control processes that ensure safe, compliant... ...transformational change. Able to adjust plans, priorities and strategies in response...RiskTemporary workWork experience placementLocal area- ...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, policy...RiskFull timePart timeSeasonal work
- ...improve provider documentation and create an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities include arranging educational sessions, identifying educational needs from reports, preparing reports on...RiskRemote job
- ...PNC is seeking a Senior Credit Risk Review Advisor to conduct independent assessments of credit exposures in Raleigh, NC. The role involves analyzing complex credit transactions, executing file reviews, and managing review engagements while providing expert risk insights...Risk
$95.3k - $158.8k
...Global Legislation AI Content Optimization Lead drives AI-first transformation for... ..., providing visibility on effectiveness, risks and opportunities* Keep abreast of market... ...other need that requires accommodation or adjustment, please let us know by completing our Applicant...RiskLocal area- ...workforce forecasting, call pattern monitoring, and real-time schedule adjustments. Ensure compliance with UCC training program modules and... ...successfully obtain and maintain a Tier 1 Investigation (Low Risk). One or more Help Desk Institute (HDI) certifications or formal...RiskContract workWork at office
$113k - $190k
A leading financial institution in Raleigh, NC is seeking a SOC 2 Program Lead. The role involves managing the SOC 2 compliance program,... ...sustained compliance. Candidates should have extensive experience in risk management and possess relevant certifications. This full-time...RiskRemote jobFull time- 慨正橡扯 seeks a Strategic Analytics Associate to enhance risk management and compliance in Business Banking. You will generate actionable insights from complex datasets and develop strategies to balance growth and risk effectively. The ideal candidate possesses a Bachelor...Risk
$84.63k - $112.84k
...and expectations are high. We’re hiring a Lead Corporate Investigator to lead complex... ...situations—requiring the ability to assess risk, navigate competing perspectives, and deliver... ...24,122 in these states: AK CA CT DC DE IL MA MD NJ NY TX VA WA Benefits Health, Life,...RiskRemote work- ..., CA, CO, DC, FL, GA, IL, MD, MA, MI, NJ, NY, NC, PA, SC, TX, VA... ...expertise. The Ipas Network Risk Service Node is responsible for... ...and ethics. The Network Risk Analyst plays a critical role in strengthening... ...experience creating and leading training programs. Strong...RiskWork at officeLocal areaRemote work
- ...quality software, minimizing risks while maximizing speed and productivity... ...a combination of industry-leading tools, services, and... ...seeking a Lead Sales Planning Analyst to support GTM Planning across... ...changes, and in-year business adjustments Maintain headcount and...Risk
- ...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$165k - $225k
...company to succeed in building honest financial products. The Security Risk Management team is evolving beyond traditional governance, risk,... ...tooling that protect Affirm and our customers. What You'll Do Lead and mature Affirm 's Security Third Party Program, including the...RiskFlexible hours- McGough is seeking a Director, Federal Compliance to lead compliance for the Federal Division, ensuring alignment with regulatory and contractual requirements. The role involves governance, risk management, and advisory functions across various teams to identify compliance...Risk
- Grant Thornton seeks an HR Risk Operations Project Manager to lead complex HR risk, compliance, and operational programs from strategy through execution. You will partner with People Experience, Legal, Compliance, HRIS, Payroll, Finance, and business stakeholders to translate...Risk
- ...actionable strategies. The ideal candidate should possess a Ph.D. in a quantitative field and have extensive experience in leading teams to enhance credit and risk management. We offer competitive rewards and comprehensive benefits to support our employees. #J-18808-Ljbffr 慨正橡...Risk
- A financial institution is seeking a professional for a risk management role that involves analyzing data trends and producing reports to identify potential risks. The ideal candidate will have a Bachelor's degree with 4 years of relevant experience, or a High School Diploma...RiskRemote job
- JPMorganChase is seeking a Privacy Strategy Lead to shape a robust privacy and data risk management program across Consumer and Community Banking. You will translate regulatory changes into actionable outcomes, partnering with Legal, Compliance, Product, and Engineering...Risk
- JPMorgan Chase is looking for a Vice President in Risk Management - Strategic Analytics to lead complex analytical projects within the Credit Risk Analytics function. This role includes developing strategies based on data analysis to enhance business effectiveness. The...Risk
- First Citizens Bank is looking for an Applied Responsible AI Lead in Raleigh, NC. This senior role involves managing AI initiatives across governance, regulatory compliance, and risk assessment. You will partner with teams to ensure practical and repeatable AI delivery...Risk
- First Citizens Bank in Raleigh, NC, seeks a supervisor to lead a team resolving past due retail, mortgage, and small business loans within... ...Resolution. This hybrid role combines hands-on leadership with risk management to mitigate losses and improve processes. You will...Risk
- ...team. You will own privacy and regulatory programs across our SaaS platform, including data mapping, policy implementation, and vendor risk management. Collaborate with multiple business units to interpret global regulations, implement controls, and deliver role‑specific...Risk
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Lead Actuarial Analyst, MA Risk Adjustment. Be the first to apply!
Related searches
- actuarial analyst Raleigh, NC
- healthcare actuary Raleigh, NC
- financial actuary Raleigh, NC
- consulting actuary Raleigh, NC
- pricing actuary Raleigh, NC
- senior quantitative risk analyst Raleigh, NC
- it risk analyst Raleigh, NC
- risk consultant Raleigh, NC
- operational risk consultant Raleigh, NC
- risk analyst Raleigh, NC


