Sr. Medicare Bid Pricing Actuarial Analyst- REMOTE IN CA, OR OR WA - McCulloh Consulting

We are looking for a Senior Actuarial Analyst with Medicare Bidding experience who will:

• Be responsible for developing and maintaining actuarial models, analyzing data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans

• Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical background

• Be instrumental in developing and executing pricing strategies, ensuring compliance with regulatory guidelines, and providing critical insights to enhance the performance of our Medicare Advantage plans

Responsibilities:

• Developing and implementing bid pricing strategies as well as analytical rigor and speed for assessing product design impacts on financial performance for Medicare Advantage plans to optimize performance

• Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements

• Collaborating with product, market, executive, and other cross-functional teams to incorporate market trends, competitive analysis, and organizational goals into pricing decisions.

• Developing key inputs and/or assumptions in support of the annual Medicare Advantage bid

• Conducting sensitivity analyses and scenario testing to assess the impact of various factors on bid pricing outcomes

• Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to identify trends and patterns

• Working closely with data analysts and actuaries to ensure the accuracy and completeness of data used in the pricing process

• Staying informed of changes in risk adjustment methodologies and assess their implications for pricing and financial performance

• Generating regular reports for senior management, highlighting key performance indicators and providing insights into financial results

• Analyzing large datasets to identify trends, patterns, and areas for improvement in pricing methodologies

Qualifications:

• Bachelor's Degree in Statistics, Mathematics, Actuarial, Finance, or another related field of study

• Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation is preferred

• 5+ years of healthcare actuarial experience with at least 2 years of Medicare Bid experience

• 2+ years of actuarial experience

• Experience with writing queries in SQL or another programming language

• Demonstrated experience applying project management skills in data-related and financial analysis projects

• Associate of the Society of Actuaries (ASA) or Fellow Society of Actuaries designation is preferred