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Lead Actuary Medicare Advantage

Horizon Blue Cross Blue Shield of New JerseyHopewell, NJ - Remote3w ago
RemoteMedicare AdvantagePricing & RatingBusiness Intelligence & ReportingPredictive Modelling & ML

Role Summary

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HIGHLIGHTS

Lead Health actuary role focused on Medicare Advantage bid pricing and forecasting. You will build internal tools, perform member- and cohort-level profitability analysis, and communicate results to stakeholders. Senior-level, remote role based in the NJ/NY/PA/CT/DE region (Hopewell, NJ preferred).

JOB DESCRIPTION SUMMARY

  • Lead Medicare Advantage bid pricing and forecasting for joint-venture business
  • Build internal tools and member-level profitability analyses
  • Perform forecasting, variance investigation, and ad-hoc analyses
  • Communicate results to senior leadership and stakeholders
  • Remote role requiring residence in NJ, NY, PA, CT, or DE

DOMAIN EXPERTISE

  • Medicare Advantage bid pricing
  • Medicare Advantage bid regulations and instructions
  • Member-level profitability analysis
  • Forecasting and profitability analysis

KEY REQUIREMENTS

  • 5+ years of Medicare Advantage actuarial bid pricing experience
  • Bachelor's degree required (Math/Stats/Actuarial preferred)
  • Expert Excel skills
  • Advanced proficiency with SAS or SQL
  • Must reside in NJ, NY, PA, CT, or DE

TECH STACK

  • Excel
  • PowerPoint