Medicare Advantage Pricing Actuary
Devoted Health
- Salary
- $175k - $250k
- Experience
- 8+ Years
Role Summary
Role type
Pricing partner to live business
Closer to a pricing partner than a modelling-heavy IC because benefit and market trade-offs are made with operational and executive stakeholders, not in isolation.
Senior Health actuarial pricing role focused on Medicare Advantage in the United States. You will lead Part C and Part D bid strategy, benefit pricing, CMS compliance, risk adjustment analysis, and bid-model execution while partnering with clinical, finance, market, and executive stakeholders. The role requires 8+ years of healthcare actuarial experience, including 5+ years in Medicare Advantage bidding.
Requirements
Must have
- 8+ years of progressive healthcare actuarial experience
- At least 5 years focused on Medicare Advantage bid pricing and CMS bid submission
Strongly preferred
- Proven track record of driving complex time-sensitive projects to completion on schedule
- Advanced proficiency in actuarial modeling, claims data extraction, and financial modeling tools (SQL, Python, R, SAS, or advanced Excel)
- Thorough understanding of Medicare Advantage pricing mechanics, CMS risk adjustment models (CMS-HCC, RxHCC), Star Ratings impacts, and benchmark calculations
- Exceptional interpersonal skills with track record of cross-functional collaboration
Nice to have
- Associate (ASA) or Fellow (FSA) of the Society of Actuaries and MAAA
- Experience interfacing with reserving, underwriting, risk adjustment operations, or medical economics functions
- Comfort operating in a fast-paced, high-growth startup environment
Skills & Domain
ToolsExcel
DomainMedicare Advantage bid pricingCMS regulatory compliance (Part C/D, risk adjustment, Star Ratings)Healthcare actuarial experienceRisk adjustment (HCC/RxHCC)Product and benefit pricing strategy