Senior Actuarial Analyst – Risk Adjustment

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Apply mathematics, probability, statistics, finance, and business principles to calculate financial outcomes • Assist with developing analyses of statistical data and other pertinent information • Analyze and evaluate required premium rates • Assess cash reserves and liabilities to enable payment of future benefits • Develop and run data reports • Assist with determining the equitable basis for distributing money for insurance benefits • Support risk adjustment programs through accurate capture, validation, and reporting of member health conditions • Partner with clinical, operational, and coding teams to improve documentation accuracy and maintain regulatory compliance • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Bachelor’s degree in a related field or equivalent experience • Combination of years of experience and actuarial exams passed must equal or exceed 5 under the Rule of 5 • Experience in healthcare, preferably Medicare Advantage, ACA, or Risk Adjustment • Advanced Excel skills, including Pivot Tables, Power BI, and Excel queries • Coding experience with SQL preferred, SAS, R, or similar tools • Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future • Ideal schedule is in the Central or Eastern Time zones

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work • Remote work from home • Comprehensive actuarial exam support • Mentorship • Continuous learning opportunities • Collaborative and supportive team environment