Actuary

A leading actuarial and healthcare consulting firm is seeking a Senior Consulting Actuary to support Medicare Part D and Medicare Advantage clients across pricing, bid development, forecasting, and regulatory strategy. This individual will serve as a key advisor to health plans, helping clients navigate the evolving Medicare landscape while developing competitive and financially sound Part D pricing strategies. The ideal candidate will possess deep expertise in Medicare Part D bid development , pricing methodologies, CMS regulations, forecasting, and financial modeling. This role offers significant client exposure and the opportunity to influence strategic decision-making for some of the nation's leading health plans. Lead Medicare Part D and MAPD bid development projects for health plan clients. Develop and review key bid assumptions including trend, formulary, membership, risk scores, rebates, low-income subsidy impacts, and benefit changes. Perform pricing analyses, financial forecasting, and profitability assessments to support bidding strategies. Advise clients on Medicare regulatory changes, CMS guidance, Inflation Reduction Act impacts, and emerging market trends. Support bid desk reviews, CMS audit requests, and annual bid submission processes. Conduct competitive market analyses and recommend strategies to improve pricing performance and member value. Partner with pharmacy, clinical, finance, product, and underwriting teams to develop integrated pricing solutions. Build and enhance actuarial models used for Medicare pricing, forecasting, and scenario testing. Present findings and strategic recommendations to client executives and senior stakeholders. Mentor junior consultants and provide technical oversight on actuarial deliverables. Contribute to business development initiatives and cultivate long-term client relationships. Qualifications ASA or FSA designation; MAAA preferred. 5+ years of actuarial experience with a focus on Medicare Advantage and/or Medicare Part D. Direct experience supporting Medicare Part D bid development and pricing. Strong understanding of CMS bid requirements, formulary design, risk adjustment, rebates, and Medicare regulations. Experience working with Medicare bid assumptions, forecasting models, and financial projections. Proven ability to communicate complex actuarial concepts to non-technical stakeholders. Advanced Excel skills required; experience with SQL, SAS, Python, R, or actuarial modeling tools preferred. Prior consulting experience or significant client-facing experience is highly desirable. Preferred Experience Medicare Part D bid strategy and pricing optimization. CMS bid audits, desk reviews, and regulatory compliance. MAPD/PDP product development and benefit design. Pharmacy trend analysis, rebate forecasting, and formulary evaluations. Financial forecasting, budgeting, and long-range strategic planning. Leadership of actuarial projects and mentoring of junior staff. Desired Skills and Experience Medicare Part D Medicare Part C Bids Actuary ASA FSA #J-18808-Ljbffr