Responsible for being the subject matter expert for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources to identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required.
Analyze risk score results calculate financial impact and identify trends or other issues related to risk scores. Calibrate risk adjustment models based on state programs. Develop and lead actuarial studies related to risk scores and present findings to leadership. Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting. Identify opportunities for improvement in risk adjustment programs and develop advocacy accordingly.
Required Education: Bachelor's Degree in Mathematics, Statistics, or Economics.
Required Experience: 1-2 years.
Required License, Certification, Association: Must have passed at least 2 actuarial exams.
Preferred Experience: 3-4 years.
Pay Range: $77,969 - $141,371 / ANNUAL. Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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