Associate Actuary; CMS Regulatory & Bid Pricing

Summary

Curana Health is seeking an experienced Health Plan Actuary to support critical financial, regulatory, and analytical functions across our Medicare Advantage lines of business.

The ideal candidate brings deep technical expertise in healthcare actuarial science and the ability to communicate complex findings to finance, clinical, and executive stakeholders. You will play a central role in CMS bid development, risk adjustment strategy, reserve modeling, and regulatory compliance at a company with over 2,400 employees and significant growth momentum.

• Lead CMS bid development and HPMS filing for Medicare Advantage plan years
• Build and maintain IBNR reserve models; support monthly close and financial reporting
• Perform risk adjustment modeling, HCC analysis, and CMS payment reconciliation
• Monitor and respond to CMS data systems including HPMS, MARx, and RAPS/EDPS
• Support RADV audit preparation and encounter data quality review
• Develop Part D pricing models and support Part D reconciliation processes
• Translate actuarial findings into clear, actionable insights for non-actuarial audiences
• Partner cross-functionally with finance, clinical, compliance, and network teams
• Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles

Credentials & Education

• Associate of the Society of Actuaries (ASA) required;
  Fellow (FSA) strongly preferred
• Member of the American Academy of Actuaries (MAAA) preferred
• Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field

Experience

• 5 to 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings
• Minimum 2 years of direct experience working with a Medicare Advantage health plan (required)
• Prior experience with ISNP, D-SNP, or dual-eligible populations strongly preferred
• Hands‑on CMS bid development and HPMS filing experience
• Risk adjustment modeling, HCC analysis, and CMS payment reconciliation experience
• Part D pricing and/or reconciliation experience a plus
• Exposure to RADV audit methodology and encounter data quality a plus

Technical Skills

• Advanced proficiency in Excel and actuarial modeling tools
• Experience with SAS, R, Python, or SQL for data extraction and analysis
• Familiarity with CMS data systems including HPMS, MARx, and RAPS/EDPS
• Ability to work with large claims datasets and synthesize findings clearly

Core Competencies

• Communication:
  Translates complex actuarial findings into clear, actionable insights for non-technical audiences including finance, clinical, and executive leadership
• Project Management:
  Manages multiple deliverables across competing deadlines, including bid season, monthly close, and CMS filings
• Collaboration:
  
  Serves as a trusted cross-functional partner to finance, clinical, compliance, and network teams
• Attention to Detail:
  Maintains strong documentation habits with a CMS audit environment in mind
• Adaptability:
  Comfortable operating in a fast-moving, often ambiguous environment typical of growing health plans