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Actuarial Risk Adjustment Jobs (NOW HIRING)

Centene

Sr. Actuarial Analyst - Risk Adjustment

OR · On-site +1

$70K - $126K/yr

The Senior Actuarial Analyst is responsible for supporting risk adjustment programs by ensuring the accurate capture, validation, and reporting of member health conditions. This role partners with ...

Centene

Sr. Actuarial Analyst - Risk Adjustment

$70K - $126K/yr

The Senior Actuarial Analyst is responsible for supporting risk adjustment programs by ensuring the accurate capture, validation, and reporting of member health conditions. This role partners with ...

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Actuarial Risk Adjustment information

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$22K

$93.5K

$154K

How much do actuarial risk adjustment jobs pay per year?

As of Aug 19, 2026, the average yearly pay for actuarial risk adjustment in the United States is $93,525.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What is actuarial risk adjustment?

Actuarial risk adjustment is a process used primarily in health insurance to make financial adjustments based on the underlying health status and expected costs of insured populations. This method helps ensure that insurance plans are fairly compensated for taking on higher-risk individuals, preventing insurers from only enrolling healthier people. By analyzing data such as age, gender, and medical history, actuaries create models that predict healthcare costs, which are then used to adjust payments or premiums. This supports fairness and sustainability in insurance markets while promoting access to care for all risk groups.

What are the key skills and qualifications needed to thrive as an actuarial risk adjustment specialist, and why are they important?

To thrive as an Actuarial Risk Adjustment Specialist, you need strong analytical abilities, a solid foundation in mathematics, statistics, or actuarial science, and typically a relevant degree or actuarial exam progress. Familiarity with data analysis tools like SAS, SQL, or Python, as well as knowledge of risk adjustment models and healthcare payment systems, is crucial. Exceptional attention to detail, problem-solving skills, and effective communication help professionals interpret complex data and explain findings to diverse stakeholders. These competencies ensure accurate risk assessments, drive fair reimbursement, and support data-driven decision-making in healthcare finance.

What are some common challenges faced in actuarial risk adjustment roles, and how can they be addressed?

Professionals in Actuarial Risk Adjustment often encounter challenges such as managing large and complex datasets, keeping up with evolving regulatory requirements, and ensuring the accuracy of risk score calculations. These challenges can be addressed by staying current with industry regulations, leveraging advanced analytical tools, and collaborating closely with data scientists, underwriters, and compliance teams. Continuous professional development and strong communication skills are also key to effectively navigating this dynamic environment.

What is the difference between Actuarial Risk Adjustment vs Actuarial Data Analyst?

AspectActuarial Risk AdjustmentActuarial Data Analyst
Required CredentialsActuarial exams, ASA or FSA designationTypically a bachelor's degree, some actuarial exams
Work EnvironmentInsurance companies, healthcare payers, government agenciesInsurance firms, consulting, healthcare organizations
Industry UsageFocuses on adjusting risk models for fairness and accuracyAnalyzes data to support actuarial models and business decisions

Actuarial Risk Adjustment specialists focus on modifying risk models to ensure fairness and accuracy in healthcare or insurance payments, often requiring advanced actuarial credentials. In contrast, Actuarial Data Analysts primarily analyze data to support actuarial models and business strategies, usually with less emphasis on actuarial certification. Both roles work within similar environments but serve different functions within the industry.

More about Actuarial Risk Adjustment jobs

What cities are hiring for Actuarial Risk Adjustment jobs?

Cities with the most Actuarial Risk Adjustment job openings:

What states have the most Actuarial Risk Adjustment jobs?

States with the most job openings for Actuarial Risk Adjustment jobs include:

What job categories do people searching Actuarial Risk Adjustment jobs look for?

The top searched job categories for Actuarial Risk Adjustment jobs are:

Actuarial Risk Adjustment jobs near you
Infographic showing various Actuarial Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $93,525 per year, or $45 per hour.

Sr. Actuarial Analyst - Risk Adjustment

Centene

OR • On-site, Remote

$70K - $126K/yr

Full-time

Medical, Retirement, PTO

Posted 16 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 404 frontline employees who took The Breakroom Quiz

14th of 888 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Position Purpose: Assist in financial analysis, pricing and risk assessment to estimate outcomes on our Risk Adjustment Actuarial Services team.

What's appealing about this role: The Senior Actuarial Analyst is responsible for supporting risk adjustment programs by ensuring the accurate capture, validation, and reporting of member health conditions. This role partners with clinical, operational, and coding to improve documentation accuracy and maintain compliance with regulatory requirements.

Our actuarial development program is designed to support your success through comprehensive exam support, mentorship, and continuous learning opportunities. You'll join a collaborative and supportive team that values knowledge sharing, celebrates exam progress, and is invested in helping actuaries grow and succeed throughout their careers.

In this Senior Actuarial Analyst role, you will:

  • Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes
  • Assist with developing analysis of statistical data and other pertinent information
  • Analyze and evaluate required premium rates
  • Assess cash reserves and liabilities enable payment of future benefits
  • Develop and run data reports
  • Assist with determining the equitable basis for distributing money for insurance benefits
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor's degree in related field or equivalent experience. Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams.

License/Certification: Combination of years of experience and number of actuarial exams passed equals or exceeds 5 (Rule of 5). For example, 2 years of actuarial experience and 3 passed actuarial exams

Preferred skills:

  • Experience in healthcare: Medicare Advantage (MA), ACA, or Risk Adjustment
  • Advanced Excel skills: Pivot Tables, Power BI, Excel queries.
  • Coding Experience: SQL (Preferred), SAS, R, etc.

Applicants for this role have the flexibility to work remotely from home anywhere within the continental United States. To support the needs of the business, ideal schedule is Central or Eastern Time zones.

Note: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Pay Range: $70,100.00 - $126,200.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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