JOB DESCRIPTION

Job Summary

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

2-4 Years

Required License, Certification, Association

Must have passed at least 3 actuarial exams.

Preferred Experience

5-6 Years

Preferred License, Certification, Association

ASA or near ASA

 

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.

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