Medicare Advantage Actuary - CMS Bid & Risk Modeling Lead
Curana Health
Curana Health is hiring an experienced Health Plan Actuary in Idaho to support financial and analytical functions across Medicare Advantage lines. The ideal candidate has strong actuarial expertise, preferably 5-8 years in healthcare settings. Responsibilities include leading bid development, risk adjustment modeling, and collaborating with finance and clinical teams. An ASA credential is required, with FSA preferred. Must be skilled in Excel and data analysis tools like SAS and Python, and able to communicate complex findings to diverse stakeholders. #J-18808-Ljbffr
$162k - $302.4k
...development of pricing models and their use... ...strategy for Medicare and State-... ...business. Lead Enterprise Government Actuarial Areas, which... ...Medicare bid filings,... .... Support risk adjustment team... ...of Medicare Advantage bids. Oversee... ...(e.g., CMS, New York Department...CmsRiskWork experience placement- A leading financial services provider in Kentucky is seeking an experienced actuary to lead the annuities modeling team. This role involves overseeing the production process, implementing new... ..., and ensuring compliance with model risk management standards. The ideal...RiskRemote work
- ...Position Title: Senior Actuary - Medicare Strategy Location:... ...primary focus on Medicare Advantage. It involves close... ...product, finance, and risk adjustment teams to ensure... ...Core Responsibilities Lead actuarial initiatives... ...regulatory bodies such as CMS and state health...CmsRiskFull timeWork at officeRemote work
$81.07k - $129.71k
...seeking a motivated Actuarial Analyst to join our Medicare Pricing Team. In this... ...and actuarial models. Builds model enhancements... ...agencies (NCDOI, CMS). Retrieves and validates... ...support Enterprise Risk Management.... ...Previous Medicare Advantage experience a plus SQL...CmsRisk- EmblemHealth seeks a Medicare Actuary in New York, NY, to support pricing, forecasting, and bid development for Medicare Advantage and Part D products. The ideal candidate will have 5-8+ years of relevant experience, a bachelor’s degree in Actuarial Science or related field...Suggested
$77.76k - $149.04k
...Summary of Job Lead and coordinate all phases of external regulatory audits across Medicare Advantage, Medicare Part D, Medicaid Managed Care (... ...prepare for audits, minimize audit risk, and protect the organization... ...of HHS ACA RADV IVA Audits, CMS MA contract level RADV Audits...CmsRiskContract workFor contractorsWork experience placementWork at officeRemote work$130k - $150k
...Position: Modeling Actuary - Risk Location: Remote Salary: $130,000-150,000 + Bonus Actuarial Summary This actuary will support actuarial model validation activities within a growing model risk team, focusing on independent review, documentation, and clear communication...RiskRemote work- ...Consulting Actuary – ACA Risk Adjustment As a Consulting Actuary – ACA Risk Adjustment, you will play a pivotal... .... Your responsibilities will include leading pricing strategies, evaluating advanced care management models, conducting competitive benchmarking analyses...CmsRisk
$110k - $120k
...Digital Insurance LLC in the United States seeks an Actuary to analyze risk, pricing, and financial exposure for insurance products. The ideal... ..., performing demographic analyses, and building predictive models. A competitive salary range of $110,000 to $120,000 per year...Risk- ...014 We're seeking a highly skilled and analytical actuary to support their Personal Lines business. This individual... ...for developing and maintaining actuarial models that directly contribute to pricing strategies, risk assessment, and overall company performance. The position...RiskWork at officeRemote workFlexible hours
$130k - $150k
...Smith Hanley Associates is looking for a Modeling Actuary to join their model risk team. This remote role involves validating actuarial models and ensuring clear communication of results. The ideal candidate will have 5–7+ years of experience in life, annuity, or long-...RiskRemote work- ...A leading reinsurance company is seeking an experienced Actuary to join its Modeling & ALM team in the Eastern United States. The successful candidate will lead model development and validation activities, ensuring accurate financial reporting and strategic decision-making...Remote work
$77.76k - $149.04k
...setting strategies. Lead projects to analyze... ...alternatives. Coordinate the actuarial staff as needed to... ...authority (e.g., CMS, New York Dep't of Health... ...Work closely with Risk Adjustment and other areas... ...reports accountable for Medicare and State Sponsored areas...CmsRiskWork experience placementRemote work$150k
...The Jacobson Group is seeking an Actuary to join its team in Arizona. The role involves cash flow testing, actuarial modeling, and supporting various functions including valuation and risk management. Candidates will work collaboratively within a small actuarial staff,...RiskRemote workRelocation package- ...interests of our cedants and their policyholders. The Actuary will serve as a key contributor within the Modeling & ALM team, leading model development, execution, and validation... ...for US GAAP, Bermuda EBS/BSCR, Liquidity Risk, Financial Planning and Analysis (FP&A),...RiskWork at officeRemote work
- ...strategic, high-impact actuarial leader to serve as... ...– Actuary, Medicare. This role provides... ...government program risk, reserve adequacy,... ...forecasting, and predictive modeling. The VP will... ...Responsibilities Lead actuarial... ...knowledge of Medicare bidding, pricing, and risk...RiskRemote work
$142.3k - $195.7k
...Lead Solutions Architect Humana is looking for... ...initiatives such as HEDIS, risk adjustment, and... ...requirements—including CMS interoperability compliance... ...microservices, service mesh, data modeling, data architecture (... ...life for people with Medicare and Medicaid, families,...CmsRiskBi-weekly payFull timeTemporary workWork at officeWork from homeHome office- MetroPlusHealth is seeking a Risk Adjustment Program Manager in New York to develop strategies... ...analysts, ensuring compliance with CMS regulations, and improving clinical outcomes... ...analytical skills, particularly in risk adjustment models. This position promises a chance to...CmsRisk
- Eerstelijnszorg Zoetermeer is looking for a P&C Risk Actuary in New York City. The ideal candidate will support risk and capital modeling, including Stress Testing, ORSA, and ERM. Applicants should have pre-ACAS qualifications and experience in P&C insurance capital modeling...Risk
- ...qualified underwriters, giving you a manageable risk profile with potential equity upside. By... ...Parental Leave About the role As the Lead Actuary, you will lead pricing, analytics, and... ...rating and loss‑sensitive pricing models for complex commercial programs. Produce...RiskLive inWork at officeRemote workVisa sponsorshipWork visaShift work
$120k - $150k
American International Group is seeking an experienced Actuary - Risk Management to assist with independent reviews of policyholder liabilities and pricing models. The position requires a strong analytical background, with a minimum of 7 years in actuarial or risk management...Risk- * Assist the Annuities Model Lead with setting the vision for the team and translating strategic... ...and lines of business* Assist actuarial internal customers with Moody’s AXIS modeling... ...inputs* Ensure team’s adherence to model risk management standards, including...RiskRemote jobTemporary workCasual workWork at office
$118.7k - $207.8k
...working closely with underwriters, Alternative Risk Solutions professionals and primarily the... .... You will have exposure to both UW and Actuarial leadership teams through quarterly... ...deals that fall out of scope of the pricing model Provide training and guidance to...CmsRiskFlexible hours- ...AI Modeling Lead Join a team where you will remain deeply technical and hands-on while elevating... ...while maintaining strong technical and risk standards. ~ Knowledge of... ...data across Chase to build competitive advantages for the businesses while providing value...Risk
$150k - $170k
Flat referral fee: $6000-6500 I&CM Data and AI Risk Governance Lead Location: New York, NY (Onsite) Sponsorship: No visa sponsorship available... ...level KPIs and KRIs to monitor risks related to data and AI models. Qualifications Minimum of 8 years of relevant experience,...CmsRiskVisa sponsorshipFlexible hours$83.43k - $185.4k
9025 CVS Shared Services Resources LLC is seeking an experienced actuarial professional to join our team in Oklahoma. The role involves conducting modeling activities for the growing Government Services PartD business, requiring strong technical skills in SAS and large...Full time$83.43k - $185.4k
Hispanic Alliance for Career Enhancement seeks an experienced actuary for a full-time role focused on enhancing Part D business processes. You will conduct modeling, oversee components, and apply critical thinking to solve complex problems using tools like SAS and SQL....Full time$83.43k - $185.4k
...Hispanic Alliance for Career Enhancement is seeking an experienced actuary to join their team supporting CVS Health and Aetna's Government... ...technical expertise and focuses on developing and maintaining models and processes related to Part D. Applicants should have a...Full time$130k - $173k
...Global Career Site Implementation Lead - 18-24 Month Project Job... ...alignment, execution quality, and risk-aware delivery. Key... ...SmartRecruiters or similar), careers site CMS tools, analytics, and... ...systems implementations, operating model changes, or process standardization...CmsRiskFull timeWork at officeLocal areaWork from homeWorldwide$70k - $80k
...building a healthcare delivery model that ensures the highest... ...change. Your Role As a Lead CDI Coder you are... ...regulatory changes, including Medicare and Medicaid guidelines... ..., such as HEDIS, CMS, and other contractual or... ...performance measures Knowledge of risk adjustment methodology...CmsRiskFull timeLocal areaRemote work
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