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Sr. Medicare Bid Pricing Actuarial Analyst- REMOTE IN CA, OR OR WA

Remote: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)
Work from: 
Japan, Oregon (USA), United States

Offer summary

Qualifications:

Bachelor's Degree in relevant field, 4+ ASA exams preferred, 5+ years of healthcare actuarial experience, 2+ years of Medicare Bid experience, Experience with SQL or programming.

Key responsabilities:

  • Develop and implement bid pricing strategies
  • Ensure compliance with Medicare bid requirements
  • Collaborate with cross-functional teams
  • Conduct sensitivity analyses on bid pricing
  • Analyze healthcare claims data for trends
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McCulloh Consulting Human Resources, Staffing & Recruiting Startup https://www.mccullohconsulting.net/
2 - 10 Employees
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Job description

We are looking for a Senior Actuarial Analyst with Medicare Bidding experience who will:

  • Be responsible for developing and maintaining actuarial models, analyzing data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans

  • Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical background

  • Be instrumental in developing and executing pricing strategies, ensuring compliance with regulatory guidelines, and providing critical insights to enhance the performance of our Medicare Advantage plans


Responsibilities:

  • Developing and implementing bid pricing strategies as well as analytical rigor and speed for assessing product design impacts on financial performance for Medicare Advantage plans to optimize performance

  • Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements

  • Collaborating with product, market, executive, and other cross-functional teams to incorporate market trends, competitive analysis, and organizational goals into pricing decisions.

  • Developing key inputs and/or assumptions in support of the annual Medicare Advantage bid

  • Conducting sensitivity analyses and scenario testing to assess the impact of various factors on bid pricing outcomes

  • Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to identify trends and patterns

  • Working closely with data analysts and actuaries to ensure the accuracy and completeness of data used in the pricing process

  • Staying informed of changes in risk adjustment methodologies and assess their implications for pricing and financial performance

  • Generating regular reports for senior management, highlighting key performance indicators and providing insights into financial results

  • Analyzing large datasets to identify trends, patterns, and areas for improvement in pricing methodologies


Qualifications:

  • Bachelor's Degree in Statistics, Mathematics, Actuarial, Finance, or another related field of study

  • Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation is preferred

  • 5+ years of healthcare actuarial experience with at least 2 years of Medicare Bid experience

  • 2+ years of actuarial experience

  • Experience with writing queries in SQL or another programming language

  • Demonstrated experience applying project management skills in data-related and financial analysis projects

  • Associate of the Society of Actuaries (ASA) or Fellow Society of Actuaries designation is preferred

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Collaboration
  • Communication
  • Analytical Thinking

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