Lead Actuarial Analyst, MA Risk Adjustment

• 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).

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 talentacquisition@strivehealth.com.

We do not accept unsolicited resumes from outside recruiters/placement agencies.

Strive Health will not pay fees associated with resumes presented through unsolicited means.