One of the largest non-profit health insurers in the country is seeking a senior actuary to lead pricing, forecasting, and bid development efforts across Medicare Advantage (MA) and Part D products. This remote position will oversee the annual Medicare bid process, support strategic pricing initiatives, and lead a small actuarial team responsible for delivering insights that drive financial performance and growth.
Key Responsibilities
Medicare Bid Development & Pricing:
Lead end-to-end Medicare Advantage and Part D bid development activities, including pricing strategy, assumption setting, and CMS submissions.
Oversee pricing analyses related to product design, trend, risk adjustment, administrative expenses, and profitability.
Evaluate the financial impact of benefit and product changes and provide recommendations to leadership.
Ensure bid submissions are competitive, financially sound, and aligned with organizational objectives.
Forecasting & Financial Analysis:
Lead Medicare forecasting processes and financial performance monitoring.
Analyze key drivers, risks, and opportunities impacting Medicare product performance.
Oversee experience studies and variance analyses to support strategic planning and decision-making.
Present actuarial findings and recommendations to senior leadership and cross-functional stakeholders.
Leadership & Team Development:
Manage and mentor a small team of actuarial professionals.
Provide coaching, guidance, and professional development opportunities for team members.
Prioritize workload, allocate resources, and ensure timely completion of key deliverables.
Foster a collaborative and high-performing team environment.
Strategic Partnership & Process Improvement:
Partner with executive leadership, finance, product, and operations teams to support growth and profitability objectives.
Monitor CMS guidance, regulatory updates, and market trends to assess impacts on pricing and forecasting.
Drive actuarial process improvements, governance initiatives, and modeling enhancements.
Identify opportunities for greater efficiency, automation, and operational excellence across actuarial functions.
Qualifications:
Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Finance, or a related field.
ASA designation required (FSA preferred)7+ years of health actuarial experience.
Prior Medicare Advantage bid development experience required.1+ year of actuarial management or people leadership experience required.
Strong expertise in Medicare Advantage pricing, forecasting, and financial analytics.
Proven ability to lead projects and influence stakeholders across multiple business functions.
Excellent communication and presentation skills.
