Sr. Actuarial Analyst - Risk Adjustment
About The Position
The Sr. Actuarial Analyst supports risk adjustment initiatives through data analysis, modeling, actuarial reporting, and data validation. The role assists with financial analysis, data validation, and risk assessment to estimate outcomes. It is a non-traditional actuarial role within operations, with opportunities to develop technical, analytical, and business skills and gain exposure to business leaders and cross-functional teams. The position supports risk adjustment initiatives including data submissions, rate reconciliation, audits, and chart chase programs, with a focus on data completeness and accuracy. The role is part of Centene's Actuarial Development Program, which offers exam support and professional development opportunities. The position is fully remote within the continental United States; Eastern and Central time zones are preferred.
Requirements
- Bachelor's degree in a related field or equivalent experience.
- A combination of years of experience and number of actuarial exams passed that equals or exceeds five (Rule of 5); for example, two years of actuarial experience and three passed actuarial exams.
- Actuarial experience and demonstrated progress toward an actuarial credential through successful completion of actuarial exams.
- Strong SQL, coding, and data analytics skills working with large datasets.
Nice To Haves
- Experience with data validation, manipulation, and quality assurance.
- Experience with risk adjustment models, SAS, Snowflake, healthcare data, and process automation.
Responsibilities
- Run and analyze market-level results using CDPS+Rx or similar risk adjustment models.
- Act as the team’s point of contact for an assigned group of markets.
- Apply knowledge of mathematics, probability, statistics, finance, and business to calculate financial outcomes.
- Assist with developing probability tables based on analysis of statistical data and other pertinent information.
- Analyze and evaluate required premium rates.
- Develop and run data reports.
- Identify data issues, uncover meaningful insights, and communicate findings to support business decisions.
- Perform other duties as assigned and comply with all policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plan
- Tuition reimbursement
- Paid time off and holidays
- Flexible approach to work with remote, hybrid, field, or office work schedules
- Exam support and professional development opportunities through the Actuarial Development Program
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What This Job Offers
Job Type
Full-time
Career Level
Senior
