ZipRecruiter

Log In

1

Actuarial Risk Adjustment Jobs (NOW HIRING)

Clover Health

Senior Actuarial Analyst

Build reports to track ROI on various risk adjustment initiatives. * Support actuarial teams in the development of risk scores for forecast and bidding purposes. * Provide actuarial support on a wide ...

next page

Showing results 1-20

All JobsActuarial Risk Adjustment Jobs

Actuarial Risk Adjustment information

See salary details

$22K

$93.5K

$154K

How much do actuarial risk adjustment jobs pay per year?

As of Jul 23, 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 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.

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.
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 July 2026, with employment types broken down into 3% As Needed, 90% Full Time, 4% Part Time, and 3% Nights. Highlights an 60% Physical, 15% Hybrid, and 25% Remote job distribution, with an average salary of $93,525 per year, or $45 per hour.
Risk Adjustment Actuary

Risk Adjustment Actuary

Blue Cross and Blue Shield of Minnesota

Eagan, MN • On-site

$102K - $138K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Blue Cross Blue Shield Of Minnesota rating

5.3

Company rating: 5.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

269th of 281 rated insurance

Job description

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

Blue Cross and Blue Shield of Minnesota is hiring a Risk Adjustment Actuary in Eagan, MN.This role is part of the Risk Adjustment Analytics team, which supports enterprise-wide initiativesacross Medicare, ACA Commercial, and Medicaid.This position serves as a key technical leadership role on the team, guiding actuarial assumption development and analysis that support enterprise decision-making.

The Risk Adjustment Analytics team partners across legal, compliance, provider, and actuarial functions to support a broad range of risk adjustment work, including forecasting, pricing, audit support, and strategic initiatives.In this role, you will review and strengthen work before final delivery, help shape forecast assumptions, and support audit defense and proposed changes. You will also translate complex actuarial concepts into clear, actionable insights for business partners and senior leaders.

The ideal candidate is a credentialed actuary with strong actuarial judgment, recent knowledge of CMS model changes, and a consultative mindset. You bring the ability to independently analyze complex data, develop defendable assumptions, and support forecasting, valuation, and strategic decision-making related to risk adjustment.

You are also skilled at working cross-functionally, understanding the business context behind each request, and translating technical findings into meaningful recommendations for non-technical audiences.

Your Responsibilities

  • Research, analyze and interpret actuarial and statistical data and provide technicalassistanceto other departments. This includesidentifyingissues to be researched,determiningaffected areas, estimating theimpactand leading the resolution.

  • Develop mathematical models in connection with other departments to predictimpactof proposed changes. May also be involved in the design of these models.

  • Understand/interpret thefinancial impactof decisions made by retrieving and analyzing claim costs,revenueand/or other relevant data. Participate in the design and implementation of new products and system enhancements by providing data and recommendations toassistin evaluating the impact of the proposed benefit,systemor process changes.

  • Responsible for divisional representation on corporate projects and may have leadership roles on these teams. Independently manage, which may include directing other staff, the retrieval and analysis of data on multiple tasks or projects with little or no management involvement.

  • Act as a resource for other members of the department/division on business issues and maybe responsible fortraining and guidance of Actuarial support personnel or Analysts. Makes satisfactory progress according to the Actuarial Student Program guidelines.

  • Other specific accountabilities as assigned by management.

Required Skills and Experience

  • 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

  • ASA or above.

  • Strong oral and written communication skills.

  • Excellent PC skills. Knowledge of data retrieval languages.

  • Knowledge of BCBSMs databases or industry knowledge.

  • High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

  • Bachelor's degree.

  • FSA preferred.

  • 3+ years of risk adjustment (RA) actuarial experience preferred.

  • Demonstrated knowledge of recent CMS risk adjustment model changes and implications

  • Experience independently analyzing complex data and leading multiple risk adjustment-related projects with minimal oversight

  • Proven ability to develop and refine risk adjustment assumptions, including applying insights from evolving data and regulatory environments

  • Ability to assess the broader risk adjustment landscape and translate findings into clear, actionable assumptions and recommendations

  • Recognized as a subject matter resource for risk adjustment assumption development and strategy

Role DesignationHybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Compensation and Benefits$102,400.00 - $138,300.00 - $174,200.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

  • Medical, dental, and vision insurance

  • Life insurance

  • 401k

  • Paid Time Off (PTO)

  • Volunteer Paid Time Off (VPTO)

  • And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

What Blue Cross Blue Shield Of Minnesota employees say

Pay

Workplace

Get the full story on Breakroom

Apply