Consulting Actuary - ACA Risk Adjustment (Healthcare)

Location: Remote Flex in North Carolina or another state listed on the posting; occasional in-office visits are required, with the exact onsite expectations discussed during the interview process.

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

Company

hirify.global operates in the healthcare insurance sector and supports healthcare delivery, value, quality, and access for its customers.

What you will do

• Lead complex actuarial and analytical projects with a focus on timeliness, compliance, and quality.
• Influence ACA pricing strategies, risk adjustment performance, product design, and financial decisions.
• Assess financial targets, explain results and variances, and support profitable growth and improved healthcare value.
• Provide strategic guidance to cross-functional leaders and communicate with divisional leadership.
• Manage relationships and negotiations with vendors, auditors, regulators, and healthcare providers.
• Identify process improvements, risks, and optimization opportunities while maintaining actuarial credentials and continuing education.

Requirements

• Bachelor’s degree or advanced degree where required.
• Membership in the American Academy of Actuaries.
• Fellow of the Society of Actuaries, or ASA status with at least 9 years of relevant experience in lieu of an FSA.
• At least 7 years of relevant actuarial experience; related experience may be considered.
• Strong actuarial analysis, financial reporting, regulatory compliance, and organizational leadership skills.
• hirify.global will not sponsor employment authorization for this position.

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 and provider documentation practices.
• Experience identifying risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations.

Culture & Benefits

• Flexible remote work with intentional in-person collaboration and a few office visits each year for Remote Flex roles.
• Work-life balance, autonomy, and a community-focused healthcare environment.
• Medical, dental, and vision coverage with health and wellness programs.
• Parental leave, adoption assistance, and surrogacy assistance.
• Career development programs, tuition reimbursement, paid time off, and a 401(k) match with an annual company contribution.