Health Actuarial Analyst - Commercial Risk Adjustment
A leading healthcare organization is seeking an Actuarial Analyst with strong commercial risk adjustment experience. This role centers on running, interpreting, and communicating commercial risk adjustment model results, while representing the organization in discussions with large‑group customers, brokers, and consultants. You will support financial risk analysis, commercial risk models, actuarial documentation, and the translation of complex actuarial findings for both internal and external stakeholders.
This is a fully remote position; however, candidates must reside in one of the following states:
California, Washington, Maryland, Colorado, Oregon, Illinois, or Georgia.
Role Responsibilities
- Run and interpret commercial risk adjustment models across commercial lines of business; present results to internal leadership and external clients.
- Research financial risk exposure and complete actuarial sections of financial reports and regulatory documentation.
- Analyze product line performance, including pricing, reserves, valuation, cash flow, and related assumptions.
- Build and refine actuarial models, methods, and assumptions to support emerging business needs.
- Monitor financial risk and identify opportunities using advanced actuarial analyses.
- Clearly communicate actuarial findings, model outcomes, and financial impacts to senior leaders, employer groups, brokers, and consultants.
Must‑Have Qualifications
- Bachelor's degree in mathematics or a related field
- Minimum 5+ years of actuarial experience
- Associate of the Society of Actuaries (ASA)
- Strong commercial risk adjustment experience
- Hands‑on experience running and interpreting commercial risk adjustment models
- Ability to effectively communicate results to large‑group customers, consultants, and brokers
Required Experience
- 5+ years of actuarial experience within healthcare
- Demonstrated expertise in commercial risk adjustment
- Ability to translate actuarial model outputs for internal and external stakeholders
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