Work From Home Risk Adjustment Auditor Jobs in Oregon

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.

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