Executive Director, Actuarial
HybridMedicare AdvantageHealth OtherPricing & RatingRegulatory ReportingBusiness Intelligence & Reporting
Role Summary
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Senior health actuarial role leading Medicare Part D (Individual MAPD and PDP) product strategy, pricing, bids, and financial performance. You will own bid development and CMS audit readiness, lead forecasting and monthly close support, and partner with Pharmacy, Product, Finance, and external vendors. Director-level position based in Chicago with a hybrid work model.
JOB DESCRIPTION SUMMARY
- Lead actuarial strategy for Individual MAPD and PDP (Medicare Part D)
- Own end-to-end bid development, CMS submissions, and bid audits
- Drive quarterly forecasting and monthly close actuarial support
- Manage and develop a Medicare Part D actuarial team and vendors
- Director-level role reporting to DSVP, Pharmacy Finance and Actuarial; hybrid in Chicago
DOMAIN EXPERTISE
- Medicare Part D pricing and bid development
- Forecasting and monthly close support for Medicare products
- CMS bid audit and regulatory compliance experience
- Pharmacy benefit economics and PBM negotiation support
- Actuarial systems and applications leadership including testing
KEY REQUIREMENTS
- 10+ years of data/transactional application knowledge or group health underwriting experience
- 10+ years of management experience, including overseeing two or more departments
- Bachelor’s degree in relevant field required
- Experience leading multi-year group insurance implementation projects
- Experience with actuarial systems, testing, and creating test scripts
TECH STACK
- No tech stack specified
