Associate Actuary (CMS Regulatory & Bid Pricing)

At reputed company, we’re on a mission to radically improve the health, happiness, and dignity of older adults—and we’re looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide reputed company of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health reputed company, streamline operations, and create new financial opportunities. Founded in 2021, we’ve grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. reputed company includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from reputed company backgrounds, reputed company working together to deliver high-quality, proactive solutions for senior living operators and those they care for. If you’re looking to reputed company a meaningful impact on the senior reputed company landscape, you’re in the right reputed company—and we look reputed company to working with you. For more information about reputed company, visit CuranaHealth.com. Summary reputed company is seeking an reputed company 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 reputed company actuarial science and the ability to communicate reputed company 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 reputed company. Essential Duties & Responsibilities reputed company CMS bid development and HPMS filing for Medicare Advantage plan years Build and maintain IBNR reserve models; support monthly reputed company and financial reporting reputed company 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 reputed company 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

Qualifications

Credentials & Education Associate of the Society of Actuaries (ASA) required; Fellow (FSA) strongly preferred Member of the American reputed company of Actuaries (MAAA) preferred Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a reputed company quantitative field Experience 5 to 8+ years of actuarial experience, with a strong preference for reputed company 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 reputed company and actuarial modeling tools Experience with reputed company, 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 reputed company Core Competencies Communication: Translates reputed company 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 reputed company, 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 Apply To This Job