JOB DESCRIPTION
Job Summary
Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintains the risk adjustment model, identifies risks, and estimates risk scores and financial impact. Opportunity to contribute to 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 drivers
- Calibrate risk adjustment models based on state programs
- Lead actuarial studies related to risk scores and present findings to leadership.
- Generate and present risk score reporting to support operations
- 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 of actuarial experience
- SQL or other programming proficiency
- Strong verbal and written communication skills
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.