Manager of Actuarial Services & Medical Economics at Gold Kidney Health Plan | Acturhire

Role Summary

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HIGHLIGHTS

Manager role at Gold Kidney Health Plan, a Medicare Advantage plan. You'll lead medical economics, IBNR reserving, forecasting, and provider contract analysis. Requires 5-7 years healthcare actuarial experience, ASA or progress toward ASA, and strong SQL/VBA/Excel skills. This is a hands-on technical leadership position based in the US.

JOB DESCRIPTION SUMMARY

Lead medical economics initiatives and IBNR reserving
Perform hands-on data mining and financial modeling
Manage Medicare Advantage bid pricing and forecasting
Supervise a team of analysts and set technical standards
Present actuarial insights to CFO and executive leadership

DOMAIN EXPERTISE

Medicare Advantage (Part C & Part D)
Risk adjustment models and capitation
Provider reimbursement principles
Value-based care contract analysis
IBNR reserving and forecasting

KEY REQUIREMENTS

5-7 years healthcare actuarial or medical economics
ASA or majority of SOA exams preferred
Advanced SQL, VBA, and Excel modeling required
Medicare Advantage domain knowledge essential
US work authorization required

TECH STACK

Excel
Power_BI
Tableau