Medicare Advantage Pricing Actuary

** Job Description
***** A bit about this role:
*** The Pricing Actuary is a critical actuarial leader responsible for directing the strategy, modeling, and execution of our annual Medicare Advantage (MA) bidding process. This role demands deep, battle-tested expertise in Medicare Advantage bid preparation, rate cell modeling, CMS regulations, and risk adjustment mechanics.  Beyond pure technical depth, success in this role hinges on flawless operational execution: hit non-negotiable regulatory deadlines, bring process consistency to complex financial cycles, and work collaboratively across market leadership, clinical teams, finance, and executive stakeholders.

We place the highest value on proven real-world execution, technical precision, and collaborative leadership. While professional actuarial credentials are recognized, a track record of driving timely, accurate, and strategic MA bids is what truly defines success in this role.  
*** Your Responsibilities and Impact will include:**
* * Medicare Advantage Bid Strategy & Execution  + Annual Bid Leadership:
Direct and oversee the end-to-end development, modeling, and submission of annual Medicare Advantage (Part C and Part

D) bids, ensuring total compliance with CMS guidelines and strict adherence to statutory deadlines.  + Product & Benefit Pricing Strategy:
Partner with product, clinical, and local market leaders to design competitive benefit packages, evaluating product trade-offs, supplemental benefits, and cost-sharing mechanics against financial and growth targets.  + Assumption Development:
Establish, defend, and document core actuarial bid assumptions, including baseline utilization, unit cost trends, risk adjustment factors, administrative expense allocations, and margin targets.  
* Modeling, Technical Rigor & Process Consistency  + Actuarial Modeling & Automation:
Build, refine, and maintain scalable bid pricing models, ensuring high standards of technical accuracy, model governance, and repeatable execution across expanding market footprints.  + Sensitivity & Scenario Analysis:
Perform complex scenario testing and sensitivity analyses to quantify the financial impacts of proposed CMS payment policy changes, risk model updates, benchmark shifts, and competitive market dynamics.  + CMS Regulatory Translation:
Interpret annual CMS Call Letters, Bid Instructions, and Rate Announcements, translating regulatory changes into actionable modeling adjustments and executive strategic guidance.  
* Cross-Functional Collaboration & Strategic Alignment  + Cross-Functional Partnership:
Work seamlessly across Finance, Healthcare Economics, Clinical Operations, and Network Management to ensure bid assumptions reflect actual operational capabilities, clinical programs, and provider contracting terms.  + Data Integration & Quality Assurance:
Partner closely with data engineering and analytics teams to ensure the integrity, completeness, and accuracy of historical claims, enrollment, and risk adjustment data fed into bid models.  + Executive & Regulatory Presentation:
Prepare clear, compelling executive-level presentations summarizing bid strategy, financial returns, and risk profiles for executive leadership, board members, and regulatory reviewers.  
*** Required skills and experience:***(Hands-on execution ability, proven track record, and collaborative performance take precedence over formal degrees or certifications).  * + Core Actuarial & MA

Experience:

8+ years of progressive healthcare actuarial experience, with at least 5+ years of deep, direct focus on Medicare Advantage bid pricing, plan design, and CMS bid submission.  + Proven Track Record of Deadline Execution:
Demonstrated ability to consistently drive complex, time-sensitive…