Senior Actuary - Risk Adjustment

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.
 

Position Purpose: This Senior Actuary will serve as the primary Risk Adjustment contact for 5 to 6 Medicaid markets.

In this Senior Actuary role, you will:

• Be accountable for ensuring timely and accurate updates to Risk Adjustment Initiative Revenue and Expense for forecasting.
• Lead data driven analyses that drive change to programs and improve outcomes for our members.
• Responsible for overseeing portfolio of Medicaid Risk Adjustment initiatives and supporting our Markets and other Shared Services teams.
• Have no direct reports, but will have access to pool of actuarial and data analysts / scientists on the Risk Adjustment team.
• Ensure all data submissions to the state are complete and that all diagnosis codes received by Centene flow end to end.
• Maintain a culture of compliance for the Medicaid risk adjustment programs in their markets.
• Strengthen reporting and visibility of Risk Adjustment outcomes throughout Markets and Senior leadership team.
• Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes.

Why is this role appealing:  While this Senior Actuary position focuses directly on Medicaid, you will collaborate closely with actuaries working on various markets and lines of business. This will enable you to learn from broader team discussions about what strategies are working and which ones are not.

Preferred, yet not required experience:  Experience with risk adjustment for other government-sponsored insurance products, including Medicaid markets utilizing different models, or experience with general Medicaid rate setting, forecasting, or analysis would be considered a positive.

Education/Experience:

• Bachelor's degree in Business or related field.
• 7+ years of actuarial experience and Associate in Society of Actuaries (ASA) certification
• Or, 5+ years of actuarial experience and Fellow in Society of Actuaries (FSA) certification.

License/Certification:  Fellow or Associate in Society of Actuaries (or equivalent international certification); Member of American Academy of Actuaries (or equivalent international membership).

Preferred technical skills:  Any combination of SAS, SQL, or Teradata experience.

*Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States. While a EST, CST, or MST work schedule is preferred, we understand the importance of flexibility and will work to accommodate individual needs.*

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.  Total compensation may also include additional forms of incentives.

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