Consulting Actuary - ACA Risk Adjustment (Healthcare)

Location: Remote Flex - North Carolina, United States

Salary: $143,616–$229,786 annually, plus annual incentive bonus and benefits.

Company

hirify.global provides health insurance and healthcare services focused on improving value, quality, and access for its customers and community.

What you will do

• Lead complex actuarial and analytical projects, ensuring timely, compliant, and high-quality delivery.
• Develop pricing strategies, actuarial initiatives, and sophisticated insurance products for business segments.
• Evaluate advanced care management models and conduct competitive benchmarking analyses.
• Analyze segment financial performance, explain results and variances, and support profitable growth.
• Identify process improvements, risks, and optimization opportunities while providing strategic actuarial recommendations.
• Manage relationships and negotiations with vendors, auditors, regulators, healthcare providers, and internal stakeholders.

Requirements

• Bachelor’s or advanced degree, where required.
• Member of the American Academy of Actuaries.
• Fellow of the Society of Actuaries, or an ASA with at least nine years of relevant experience.
• At least seven years of relevant actuarial experience; related experience may be considered.
• Strong actuarial analysis, financial reporting, leadership, communication, and regulatory compliance skills.

Nice to have

• Deep experience with ACA Risk Adjustment, including HHS-HCC methodology, risk score forecasting, and financial impact analysis.
• Expertise in ACA Risk Adjustment transfer forecasting and explaining results to senior leadership.
• Knowledge of ICD-10-CM diagnosis coding, provider documentation, and risk adjustment outcomes.
• Experience identifying risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations.

Culture & Benefits

• Remote flexibility, work-life balance, and autonomy.
• Medical, dental, and vision coverage with health and wellness programs.
• Parental leave, adoption assistance, and surrogacy assistance.
• Career development programs and tuition reimbursement.
• 401(k) match with an annual company contribution and paid time off.