Staff Actuary - Medicare - Health Insurance

Summary:

We are seeking a hands-on Medicare Actuary to support pricing, forecasting, and bid development for Medicare Advantage (MA), Part D, and EGWP products. This role will support end-to-end bid season execution, Medicare forecasting, and deliver deep experience analytics to inform pricing, product strategy, and financial performance. The ideal candidate combines Medicare bid expertise, experience study rigor, and a builder mindset to improve processes, and elevate insights.

Key Responsibilities:

Bid & Pricing (MA/Part D/EGWP)

• Own actuarial components of the annual Medicare Advantage and Part D bids, including benefit pricing, trend, risk score assumptions, admin load, and margins.
• Be a collaborative partner across teams by pricing product scenarios.
• Review ongoing CMS releases and refine assumptions to monitor a rapidly changing landscape.

Forecasting

• Deliver regular forecasting with clear drivers, risks, and variances vs. plan/budget.

Requirements:

• Bachelor’s degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required
• Associate of the Society of Actuaries (ASA) required
• 5 – 8+ years relevant professional work experience and/or education required
• 4+ years health insurance actuarial experience, preferably in the managed care industry required
• Prior management experience (processes and/or staff) preferred
• A comprehensive understanding of actuarial principles and methodologies; strong mathematical and analytical skills required
• Ability to communicate effectively with Business leaders required
• Expert level skills with database, spreadsheet, and analytical software required
• Proficiency with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.) required
• Strong data querying skills using tools such as SQL or SAS Enterprise Guide preferred
• Capable with data extraction, simulations, automation required