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Actuarial Consultant

Risk Adjustment

Posted on 3/24/2023

Bright Health

Bright Health

501-1,000 employees

Leverages technology to optimize healthcare outcomes

Financial Services



Required Skills
Apache Spark
Business Strategy
Data Analysis
  • Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes
  • What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative
  • If you share our passion for changing healthcare so all people can live healthy, brighter lives - apply to join our team
  • A Bachelor's degree required in Math, Statistics, Economics, Actuarial Science, or a related field is required
  • Four (4) or more years of experience working with Medicare Advantage and/or Part D products is preferred
  • Associate in the Society of Actuaries or higher is preferred
  • Proficient in at least one high-level programming language such as Python, SAS, R, Spark, Scala
  • Expert-level knowledge of Microsoft Excel and other Office products
  • Experience with modeling and forecasting Risk Adjustment accruals
  • Intermediate to expert-level knowledge of Medicare Advantage Risk Adjustment
  • Produce, understand, and interpret internal and external analysis and reports; provide effective technical and non-technical support to internal and external stakeholders
  • Strong communication skills and ability to meet with C-Level leadership on pricing and plan-related topics
  • Experience working with big data is a big plus
  • Associateship or greater in the Society of Actuaries or commensurate years of experience
  • Work in tandem with the Risk Adjustment Director to support model development and reporting
  • Develop monthly accruals for all Medicare Risk Adjusted payments
  • Support the development of forecasting models, projections, and relevant information to inform C-Level business decisions
  • Routinely partner on shared objectives with Risk Adjustment Analytics and Operations teams
  • Develop ROI calculations for Risk Adjustment vendor contracts
  • Provide analyses related to various audits including internal, RADV, OIG, and external review
  • Support the team through modeling, market analysis, and experience to determine company growth initiatives; conduct research and data analysis
  • Perform ad-hoc data analysis
  • Support MA Bid development including Risk Adjustment trend
  • Support product and line of business strategy by working with LOB leadership
  • Individual contributor and SME for MA Risk Adjustment, supporting strategy and plan design discussions, market positioning, and regulatory landscape
  • This position will have supervisory responsibilities as the team grows
  • The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required

Bright HealthCare leverages technology to enhance healthcare delivery and optimize clinical outcomes by aligning local resources with care financing.

Company Stage


Total Funding



Minneapolis, Minnesota



Growth & Insights

6 month growth


1 year growth


2 year growth



Compensation and retirement - Performance bonus, Stock Options, 401k plan, 401k matching, Commuter assistance plans

Health and wellness - Health insurance, Dental insurance, Vision insurance, Life insurance, Disability insurance, FSA (Flexible Spending Plan), EAP (Employee Assistance Program)

Vacation and time off - Unlimited time off, Paid holidays, Flexible working hours, Maternity benefits, Paternity benefits

Values and quality of life - Public Transportation, Bike parking, Employee groups and committees, Snacks and beverages