Location: New York, NY | Atlanta, GA | Dallas, TX | Tempe, AZ (Hybrid – 3x days in office)
Salary: $130,000 – 170,000 + bonus
Position Overview
This leadership role drives the organization’s understanding of how ACA market dynamics, member risk profiles, and documentation completeness influence financial performance. Working closely with Actuarial and Finance leadership, you’ll manage the analytics that inform risk revenue assumptions, influence pricing decisions, and support monthly close activities.
You will have hands-on visibility into how federal market mechanics, competitive intelligence, and internal membership shifts translate into strategic financial outcomes. It’s a fast-moving environment where your insights will directly shape how the organization competes and grows in the marketplace.
What You’ll Do
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Build and refine models that estimate ACA risk scores and expected revenue transfers.
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Lead analytical workstreams to identify what is driving risk mix changes and financial variability.
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Support close and projection cycles with accurate, timely forecasts and explanations.
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Advance internal capabilities by improving documentation processes, model structure, and automation.
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Bring forward insights on marketplace competition and regulatory evolution.
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Produce clear, concise deliverables for senior leaders and external stakeholders.
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Partner across Product, Clinical, Data Science, and Network teams to improve risk capture performance.
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Mentor junior team members and standardize best practices across analytics workflows.
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Ensure compliance with applicable regulations and filing requirements.
What You Bring
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Bachelor’s degree in a quantitative or related field.
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5+ years of experience within actuarial analytics, financial modeling, or healthcare data analysis.
- Strongly prefer ACA Risk Adjustment, ACA Pricing/MedEcon, or Non-ACA Risk Adjustment experience.
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Fluency in SQL with a strong command of working with complex claims data.
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Strong communication and storytelling skills – able to translate analytics into financial implications.
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Ability to collaborate in a matrixed environment and influence decisions.
Bonus Qualifications
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Direct experience in ACA risk adjustment or cost forecasting.
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Understanding of health plan economics, competitive positioning, and market strategy.
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Exposure to revenue reconciliation, documentation initiatives, or provider engagement.
Why This Role Is Exciting
You’ll have the opportunity to directly influence:
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ACA revenue performance
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Market competitiveness and affordability strategy
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Long-term sustainability of key product lines
If you’re looking for a role where your technical expertise leads to tangible business outcomes and executive visibility – this is it.
