Lead Actuarial Analyst, MA Risk Adjustment

Strive Health•Raleigh, NC

12h•Hybrid

About The Position

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! 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).

Requirements

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.
Bachelor’s degree in a quantitative or health-related field (e.g., Economics, Public Health, Statistics, Health Services Research, Math, Finance).

Nice To Haves

Experience with PBI, Redshift, dbt docs is a plus.

Responsibilities

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.