Senior Actuarial Analyst - Medicare Bid - Switch4 LLC

Role: Senior Actuarial Analyst - Medicare Bid
Location: Portland, OR
Type: FTE/Permanent

Job Description:

• 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
• 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

Required 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
• 5+ years of healthcare actuarial 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

Preferred qualifications:

• Associate of the Society of Actuaries (ASA) designation
• Fellow or Associate in the Society of Actuaries (FSA or ASA)
• 2+ years of Medicare Bid experience