Senior Actuary

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Position Title: Senior Actuary - Medicare Strategy

Location: Remote

Position Overview

This role provides senior-level actuarial leadership in support of Medicare product performance, pricing strategy, and regulatory compliance. The position is responsible for guiding analytical efforts across multiple business lines, with a primary focus on Medicare Advantage. It involves close collaboration with product, finance, and risk adjustment teams to ensure financial sustainability and strategic alignment. The role also includes oversight of rate filings, reserve methodologies, and team development.

Core Responsibilities

• Lead actuarial initiatives related to pricing, reserving, and financial analysis for Medicare and other government-sponsored health plans.
• Collaborate with product management and finance to assess financial performance, including membership trends, cost drivers, and profitability.
• Identify opportunities to enhance product performance through cross-functional collaboration and data-driven insights.
• Oversee the development and submission of premium rates and cost projections to regulatory bodies such as CMS and state health departments.
• Partner with risk adjustment teams to support revenue forecasting, coding accuracy, and performance monitoring.
• Provide guidance and mentorship to actuarial staff, including those responsible for specific lines of business (e.g., ACA, Medicaid, Medicare).
• Contribute to strategic planning and execution across the organization's government business portfolio.
• Deliver clear, actionable reporting and recommendations to senior leadership.
• Perform additional duties as needed to support enterprise goals.

Qualifications

Education & Credentials

• Bachelor's degree in Actuarial Science, Mathematics, Economics, or a related field.
• ASA designation required (FSA preferred).
• Member of the American Academy of Actuaries (MAAA) required.

Experience & Skills

• 10+ years of health actuarial experience
• Proven experience in Medicare Advantage or managed care environments.
• Strong understanding of actuarial principles, reimbursement methodologies, and regulatory requirements.
• Demonstrated ability to lead complex projects and manage cross-functional initiatives.
• Effective communicator with the ability to translate technical findings into strategic insights.
• Experience managing and developing actuarial talent.
• Proficiency in Microsoft Office and data analysis tools; experience with automation and simulation techniques preferred.

• Seniority level
  
  Mid-Senior level

• Employment type
  
  Full-time

• Job function Finance
• Industries Claims Adjusting, Actuarial Services

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