Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources to identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required.
Knowledge/Skills/Abilities
Analyze risk score results – calculate financial impact and identify trends or other issues related to risk scores.
Calibrate risk adjustment models based on state programs
Develop and lead actuarial studies related to risk scores and present findings to leadership
Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting
Identify opportunities for improvement in risk adjustment programs and develop advocacy accordingly
Job Qualifications
Required Education
Bachelor's Degree in Mathematics, Statistics, or Economics
Required Experience
1-2 Years
Required License, Certification, Association
Must have passed at least 2 actuarial exams.
Preferred Experience
3-4 Years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Pay Range: $77,969 - $117,809 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Seniority level
Entry level
Employment type
Full-time
Job function
Finance and Sales
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at Molina Healthcare by 2x