Actuarial Manager, Medicare
One of the largest non-profit health insurers in the country is seeking a senior actuary to lead pricing, forecasting, and bid development efforts across Medicare Advantage (MA) and Part D products. This remote position will oversee the annual Medicare bid process, support strategic pricing initiatives, and lead a small actuarial team responsible for delivering insights that drive financial performance and growth.
This is a highly visible leadership opportunity for an experienced Medicare actuary looking to manage people while maintaining hands-on involvement in bid development, forecasting, and strategic decision-making.
Key Responsibilities
Medicare Bid Development & Pricing
- Lead end-to-end Medicare Advantage and Part D bid development activities, including pricing strategy, assumption setting, and CMS submissions.
- Oversee pricing analyses related to product design, trend, risk adjustment, administrative expenses, and profitability.
- Evaluate the financial impact of benefit and product changes and provide recommendations to leadership.
- Ensure bid submissions are competitive, financially sound, and aligned with organizational objectives.
Forecasting & Financial Analysis
- Lead Medicare forecasting processes and financial performance monitoring.
- Analyze key drivers, risks, and opportunities impacting Medicare product performance.
- Oversee experience studies and variance analyses to support strategic planning and decision-making.
- Present actuarial findings and recommendations to senior leadership and cross-functional stakeholders.
Leadership & Team Development
- Manage and mentor a small team of actuarial professionals.
- Provide coaching, guidance, and professional development opportunities for team members.
- Prioritize workload, allocate resources, and ensure timely completion of key deliverables.
- Foster a collaborative and high-performing team environment.
Strategic Partnership & Process Improvement
- Partner with executive leadership, finance, product, and operations teams to support growth and profitability objectives.
- Monitor CMS guidance, regulatory updates, and market trends to assess impacts on pricing and forecasting.
- Drive actuarial process improvements, governance initiatives, and modeling enhancements.
- Identify opportunities for greater efficiency, automation, and operational excellence across actuarial functions.
Qualifications
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Finance, or a related field.
- ASA designation required (FSA preferred)
- 7+ years of health actuarial experience.
- Prior Medicare Advantage bid development experience required.
- 1+ year of actuarial management or people leadership experience required.
- Strong expertise in Medicare Advantage pricing, forecasting, and financial analytics.
- Proven ability to lead projects and influence stakeholders across multiple business functions.
- Excellent communication and presentation skills.
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