We are looking for a Senior Actuarial Analyst with Medicare Bidding experience who will: Be responsible for developing and maintaining actuarial models, analyzing data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical background Be instrumental in developing and executing pricing strategies, ensuring compliance with regulatory guidelines, and providing critical insights to enhance the performance of our Medicare Advantage plans Responsibilities: Developing and implementing bid pricing strategies as well as analytical rigor and speed for assessing product design impacts on financial performance for Medicare Advantage plans to optimize performance Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements Collaborating with product, market, executive, and other cross-functional teams to incorporate market trends, competitive analysis, and organizational goals into pricing decisions.
Developing key inputs and/or assumptions in support of the annual Medicare Advantage bid Conducting sensitivity analyses and scenario testing to assess the impact of various factors on bid pricing outcomes Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to identify trends and patterns Working closely with data analysts and actuaries to ensure the accuracy and completeness of data used in the pricing process Staying informed of changes in risk adjustment methodologies and assess their implications for pricing and financial performance Generating regular reports for senior management, highlighting key performance indicators and providing insights into financial results Analyzing large datasets to identify trends, patterns, and areas for improvement in pricing methodologies Qualifications: Bachelor's Degree in Statistics, Mathematics, Actuarial, Finance, or another related field of study Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation is preferred 5+ years of healthcare actuarial experience with at least 2 years of Medicare Bid experience 2+ years of actuarial experience Experience with writing queries in SQL or another programming language Demonstrated experience applying project management skills in data-related and financial analysis projects Associate of the Society of Actuaries (ASA) or Fellow Society of Actuaries designation is preferred