Associate Actuary, CMS Regulatory & Bid Pricing

ActuaryActuaryFull TimeRemoteMid LevelTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

45 days ago

Salary

0

Seniority

Mid Level

Bachelor Degree5 yrs expEnglishPythonSQL

Job Description

Associate Actuary, CMS Regulatory & Bid Pricing

Curana Health

• Lead CMS bid development and HPMS filing for Medicare Advantage plan years • Build and maintain IBNR reserve models; support monthly close and financial reporting • Perform risk adjustment modeling, HCC analysis, and CMS payment reconciliation • Monitor and respond to CMS data systems including HPMS, MARx, and RAPS/EDPS • Support RADV audit preparation and encounter data quality review • Develop Part D pricing models and support Part D reconciliation processes • Translate actuarial findings into clear, actionable insights for non-actuarial audiences • Partner cross-functionally with finance, clinical, compliance, and network teams • Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles

Job Requirements

  • Associate of the Society of Actuaries (ASA) required; Fellow (FSA) strongly preferred
  • Member of the American Academy of Actuaries (MAAA) preferred
  • Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field
  • 5 to 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings
  • Minimum 2 years of direct experience working with a Medicare Advantage health plan (required)
  • Prior experience with ISNP, D-SNP, or dual-eligible populations strongly preferred
  • Hands-on CMS bid development and HPMS filing experience
  • Risk adjustment modeling, HCC analysis, and CMS payment reconciliation experience
  • Part D pricing and/or reconciliation experience a plus
  • Exposure to RADV audit methodology and encounter data quality a plus
  • Advanced proficiency in Excel and actuarial modeling tools
  • Experience with SAS, R, Python, or SQL for data extraction and analysis
  • Familiarity with CMS data systems including HPMS, MARx, and RAPS/EDPS
  • Ability to work with large claims datasets and synthesize findings clearly

Benefits

  • Health insurance
  • 401(k) matching
  • Flexible work hours

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