Actuarial Risk Adjustment Jobs (NOW HIRING)

Why Join CINQCARE?

CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care.

Position Overview

The Senior Actuarial Analyst is a high-impact analytical role responsible for supporting financial, actuarial, and strategic analytics across CINQCARE’s value-based care portfolio. This role partners closely with Finance, Healthcare Economics, Clinical, and Network teams to evaluate performance, manage risk, and advance CINQCARE’s analytics capabilities.

This position reports to the Director, Actuarial Analytics and Reporting. The Senior Actuarial Analyst should embody CINQCARE's core values, including Trusted, Empathetic, Committed, Humble, Creative, and Community­ Minded.

Key Responsibilities

· Perform actuarial analyses across Medicare Advantage, Medicaid, and ACO (REACH, MSSP) populations, including pricing/underwriting, IBNR development, forecasting, trend, and other strategic analysis.

· Support monthly close and financial reporting processes, including IBNR and P&L development.

· Analyze financial and operational performance, identifying key drivers of variance across revenue, utilization, unit cost, risk adjustment, and quality.

· Develop pro forma analyses and multi-year projections for new and renewing business.

· Support annual budget development and long-term forecasts.

· Interpret value-based contract terms and support contract performance monitoring and operations.

· Analyze large datasets, including claims, encounters, and enrollment data and Medicare Advantage (MMR, MOR, MA004) and ACO (BCDA, CCLF) data sources.

· Perform risk adjustment analytics, including RAF score monitoring and revenue impact analysis.

· Support clinical and network analytics, including provider performance, care model effectiveness, and affordability initiatives in partnership with Clinical and Network teams.

· Conduct ad hoc analytics to support executive leadership, corporate strategy, and investor materials.

· Continuously improve analytical processes, tools, and methodologies to enhance accuracy and efficiency.

· Stay current on trends in value-based care, including Medicare Advantage, Medicaid, and CMS models.

Required Qualifications

· Bachelor’s degree in a STEM field.

· 3-5 years of healthcare actuarial experience, with experience in health insurance, consulting, or value-based care strongly preferred.

· Associate or Fellow of the Society of Actuaries, or on the track to become one.

· Experience in key actuarial functions such as IBNR, pricing, forecasting, and trend analysis.

· Experience in Medicare, Medicaid, or CMS ACO models (MSSP / REACH).

· Superior Excel, data retrieval (SQL / SAS / Python), and PowerPoint skills.

· Strong analytical and problem-solving capabilities.

· Strong written and verbal communication skills.

Preferred Qualifications

· Familiarity with claims data (DRG/HCPCS/episode groupers), risk adjustment models (HCC/RAF), and value-based payment models.

· Ability to translate complex financial and healthcare data into clear, actionable insights.

· High attention to detail with strong business judgment and ownership.

· Self-motivated and results-driven, with an ability to thrive in a fast-paced environment.

· Ability to work independently while also contributing to team-based initiatives.

· Ability to demonstrate good judgment when making decisions without complete information.

The working environment and physical requirements of the job include:

In-office work is performed indoors in a traditional office setting with conditioned air, artificial light, and an open workspace.

In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.

Equal Opportunity & Reasonable Accommodation Statement

CINQCARE is an Equal Opportunity Employer committed to creating an inclusive environment for all employees. We provide equal employment opportunities to all individuals regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.

If you require a reasonable accommodation during the application or employment process, please indicate this in your application or speak with your recruiter during the hiring process.

Disclaimer

This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary.

Our Benefits

At CINQCARE, we care for our team like we care for our patients—holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.

• Medical Plans: Two comprehensive options offered to Team members.
• 401K: 4% employer match for your future.
• Dental & Vision: Flexible plans with in-network savings.
• Paid Time Off: Generous PTO, holidays, and wellness time.
• Extras: Pet insurance, commuter benefits, mileage reimbursement, CME for providers, and company-provided phones for field staff.