Actuary Manager

Description:

We are seeking an Actuarial Manager to serve as the primary owner of Astrana’s Medicare Advantage risk adjustment process. This role will have responsibility for validating data, accruing risk scores, and building a scalable, defensible risk adjustment process from the ground up. You will partner closely with our Data and Quality teams, you will be the individual ultimately accountable for interpreting results, translating them into financial accruals, and serving as the authoritative voice on risk adjustment for Finance and senior leadership. Over time, as the risk adjustment process matures, this role will have the opportunity to expand into actuarial forecasting and financial planning efforts more broadly across the business.

This role is an individual contributor role with accountability for process ownership and execution; it does not have direct people management responsibility at this time. This role will report to the Senior Manager, Actuary, and the position is open for remote work.


Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do Primary Responsibility: Risk Adjustment Ownership · Own end-to-end Medicare Advantage risk score accruals across Astrana’s $1B+ MA book of business

· Serve as the accountable owner of the risk adjustment process, including data validation, accrual methodology, and financial interpretation.

· Partner with Data to operate and refine Astrana’s internal HCC engine, while owning the validation, interpretation, and financial application of its outputs.

· Act as the internal risk adjustment subject matter expert, staying current on CMS model changes and regulatory guidance and contribute actuarial expertise into Astrana’s advocacy efforts in the space.

· Translate risk adjustment results into actionable insights for Quality, Finance, and Operations teams.