Senior Manager, Actuarial – Risk Adjustment

🔥 45 minutes ago

🏄 California, Connecticut, +3 more states – Remote

🏄 California – Remote 🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote ☕ Washington – Remote

💵 $147.6k - $193.7k / year

⏰ Full Time

🟠 Senior

📊 Actuary

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Oscar Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Develop Oscar's ability to predict risk scores and ACA market morbidity with actuaries and data scientists • Source new data for Oscar and market-level predictions • Maintain and evolve risk adjustment reporting and forecast models • Conduct research and enhance risk adjustment knowledge and capabilities • Prepare estimated risk adjustment transfer estimates for monthly closes and ongoing financial forecasts • Conduct risk adjustment analyses, including analyzing drivers of risk adjustment performance • Lead quarterly audit deliverables and maintain internal control compliance • Promote and shape actuarial best practices for automation and documentation • Maintain relationships and communication with internal and external stakeholders • Aid in onboarding analysts and integrating them into existing processes • Comply with applicable laws and regulations • Perform other duties as assigned

🎯 Requirements

• College degree or commensurate skills attainment • Associate or Fellow of the Society of Actuaries (SOA) • 6+ years of quantitative analysis experience • Strongly preferred: ACA Risk Adjustment, ACA Pricing/MedEcon, or Non-ACA Risk Adjustment expertise • Strong understanding of health insurance concepts and nuances

🏖️ Benefits

• Employee benefits • Unlimited vacation program • Annual performance bonuses • Medical benefits • Dental benefits • Vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life insurance • Disability insurance • Paid wellness time • Wellness reimbursements • Occasional travel for team meetings and company events