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Actuarial Risk Adjustment Jobs (NOW HIRING)

Strive Health

Lead Actuarial Analyst, MA Risk Adjustment

$99K - $124K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

What You'll Do 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 ...

Strive Health

Lead Actuarial Analyst, MA Risk Adjustment

$99K - $124K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

What You'll Do 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 ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · Hybrid

$72K - $82K/yr

Position Overview Risk Adjustment is a growing and critical field within Health Insurance Finance ... Management or Actuarial capacity in another industry. * Ability to work independently to ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

Position Overview Risk Adjustment is a growing and critical field within Health Insurance Finance ... Management or Actuarial capacity in another industry. * Ability to work independently to ...

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets. * Optimize Risk Adjustment Factor improvements through external vendors. * Partner with the ...

Molina Healthcare

Manager, Actuarial Services - REMOTE

$79K - $172K/yr

... Medicaid risk adjustment in multiple states. Activities include extracting, analyzing, and ... Essential Job Duties • Reviews reporting prepared by actuarial team to assure consistency and ...

Mercor

HCC Coding Leader - Risk Adjustment

San Francisco, CA · Remote

$110/hr

Experience presenting risk adjustment performance to actuarial or executive teams. Application Process (Takes 20-30 mins to complete) * Upload resume * AI interview based on your resume * Submit form ...

Posted today

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Experience presenting risk adjustment performance to actuarial or executive teams. Application Process (Takes 20-30 mins to complete) * Upload resume * AI interview based on your resume * Submit form ...

Imedica

Director, Actuarial Services

Minnetonka, MN · On-site

$150K - $257K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Actuaries use technical knowledge and business acumen to analyze financial experience, quantify ... Incorporates the impact of risk adjustment into financial projections and performance analysis

Mercor

Risk Adjustment Expert - AI Trainer

Nashville, TN · Remote

$110/hr

Experience presenting risk adjustment performance to actuarial or executive teams. Application Process (Takes 20-30 mins to complete) * Upload resume * AI interview based on your resume * Submit form ...

Posted today

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Actuarial Risk Adjustment information

See salary details

$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.

Lead Actuarial Analyst, MA Risk Adjustment

Strive Health

Seattle, WA • On-site

$99K - $124K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Job description

How You'll Make An Impact
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!
Benefits & Perks
  • Hybrid-Remote Flexibility -Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.
  • Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts.
  • Financial & Retirement Support - Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources.
  • Time Off & Leave - Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.
  • Wellness & Growth - Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.

To learn more about our offerings, click here.
What You'll Do
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). We offer a competitive Actuarial Study Program designed to help you succeed, including exam fee support, study resources, and rewards for passing exams and achieving actuarial credentials.
Essential Functions
  • 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.

Who You Are
  • A highly analytical problem-solver with a strong sense of ownership and intellectual curiosity.
  • Able to manage a high volume of recurring and ad hoc deliverables without compromising quality.
  • Comfortable navigating ambiguity and bringing structure to complex problems.
  • An exceptional communicator who can translate technical findings into actionable business recommendations.

Qualifications
  • 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.
  • Experience with PBI, Redshift, dbt docs is a plus.
  • Bachelor's degree in a quantitative or health-related field (e.g., Economics, Public Health, Statistics, Health Services Research, Math, Finance).

Annual Salary Range: $99,000 - $124,000. This position is also eligible for a target annual bonus of 10%
Final compensation will be determined based on location, experience, and qualifications.
Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.

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