Pricing Actuary-Medicare Advantage
Core
Lead the end-to-end strategy, modeling, and execution of annual Medicare Advantage (Part C and Part D) bids, ensuring compliance with CMS guidelines and statutory deadlines.
Role type
Senior IC Pricing Actuary (Medicare Advantage)
Builds
Annual Medicare Advantage bid submissions and competitive benefit packages
Domain
US Healthcare / Medicare Advantage / Actuarial Modeling
Deliverable
production ML models
Required skills
Medicare Advantage bid pricing, CMS regulations, risk adjustment mechanics, actuarial modeling, SQL, Python, R, SAS, financial modeling
Preferred skills
Actuarial credentials (ASA/FSA/MAAA), managed care perspective, startup agility
Technologies
SQL, Python, R, SAS, Excel
Responsibilities
Direct annual Medicare Advantage bid development and submission; design competitive benefit packages; establish and defend actuarial bid assumptions; build and maintain scalable bid pricing models; perform sensitivity and scenario analysis; translate CMS regulatory changes into modeling adjustments.
Seniority
Senior, hands-on IC
