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Pricing Actuary-Medicare Advantage

Devoted Health

Health/Insurer

Pricing Actuary-Medicare Advantage

Devoted Health

Waltham, Massachusetts, United States · Remote · Yesterday

Salary
$175k - $250k
Experience
8+ Years

Role Summary

Role type

Pricing partner to business leaders

Closer to a live pricing partner than a reserving/reporting role—the work is tied to annual bids, benefit trade-offs, and growth targets.

Senior Health pricing role focused on Medicare Advantage Part C and Part D bids. You will lead bid strategy, benefit pricing, CMS-compliant modeling, risk adjustment analysis, and executive presentations while partnering across product, clinical, finance, and market teams. The role is remote and associated with Waltham, Massachusetts.

Requirements

Must have

  • 8+ years of progressive healthcare actuarial experience, with at least 5+ years in Medicare Advantage bid pricing, plan design, and CMS bid submission

Strongly preferred

  • Proven track record of driving complex, time-sensitive projects to completion on schedule under regulatory deadlines
  • Advanced proficiency in actuarial modeling, claims data extraction, and financial modeling tools (SQL, Python, R, SAS, or advanced Excel)
  • Deep understanding of Medicare Advantage pricing mechanics, including Part D direct subsidy, CMS risk adjustment models (CMS-HCC, RxHCC), Star Ratings financial impacts, and benchmark calculations
  • Exceptional interpersonal skills and proven ability to work across cross-functional teams, translating actuarial concepts for non-actuarial partners

Nice to have

  • ASA or FSA and MAAA (optional, fully equivalent experience considered)
  • Experience interfacing with reserving, underwriting, risk adjustment operations, or medical economics functions
  • Comfort operating in a fast-paced, high-growth environment with continuous process evolution

Skills & Domain

ToolsExcel
DomainMedicare Advantage bid preparation and pricingCMS regulatory compliance and bid submissionRisk adjustment mechanics (CMS-HCC, RxHCC)Part C and Part D benefit designFinancial modeling for MA bids