Senior Part D Actuary
We are seeking a highly skilled and experienced Senior Actuary to lead and support actuarial functions related to Medicare Part D. This role is critical in driving pricing strategy, regulatory compliance, and financial performance for our Medicare prescription drug plans. The ideal candidate will bring deep expertise in Part D bid development, risk adjustment, and forecasting, along with strong leadership and communication skills.
Key Responsibilities
- Lead the development and submission of Medicare Part D bids, including formulary analysis, trend development, and risk score projections.
- Collaborate with cross-functional teams including Pharmacy, Finance, Compliance, and Product to ensure alignment on strategy and execution.
- Monitor and analyze Part D financial performance, identifying drivers of variance and recommending corrective actions.
- Interpret and apply CMS regulations and guidance to ensure compliance and optimize plan performance.
- Mentor junior actuaries and analysts, providing technical guidance and career development support.
- Represent the actuarial team in meetings with CMS, auditors, and internal leadership.
Qualifications
- ASA or FSA designation from the Society of Actuaries.
- Minimum 5-7 years of actuarial experience, with at least 3 years focused on Medicare Part D.
- Strong understanding of CMS bid process, risk corridors, DIR, and risk adjustment methodologies.
- Proficiency in actuarial software and tools (e.g., SAS, SQL, Excel, VBA).
- Excellent analytical, problem-solving, and communication skills.
- Ability to manage multiple priorities in a fast-paced, deadline-driven environment.
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