Medicare Advantage Pricing Actuary

Key responsibilities: Direct and oversee the end-to-end development, modeling, and submission of annual Medicare Advantage bids, ensuring compliance with CMS guidelines Partner with product and clinical leaders to design competitive benefit packages and establish core actuarial bid assumptions Build and maintain scalable bid pricing models while performing scenario testing and sensitivity analyses to assess financial impacts of regulatory changes

Required qualifications: 8+ years of progressive healthcare actuarial experience, with at least 5+ years focused on Medicare Advantage bid pricing and CMS bid submission Demonstrated ability to manage complex, time-sensitive projects with high-stakes regulatory deadlines Advanced proficiency in actuarial modeling and financial modeling tools such as SQL, Python, R, SAS, or advanced Excel Thorough understanding of Medicare Advantage pricing mechanics and CMS risk adjustment models Exceptional interpersonal skills with a proven track record of effective cross-functional collaboration