Associate Actuary (CMS Regulatory & Bid Pricing)

Associate Actuary

Curana Health is seeking an Associate Actuary to play a critical role in pricing, risk strategy, and financial performance across our Medicare Advantage lines of business. You will play a central role in CMS bid development, risk adjustment strategy, reserve modeling, and regulatory compliance at a company with more than 2,400 employees and significant growth momentum. This is a high-impact opportunity to partner cross-functionally with finance, clinical, compliance, and executive leadership in a rapidly growing, national organization.

Essential Duties & Responsibilities:

• Lead CMS (Centers for Medicare & Medicaid Services) bid development and HPMS (Health Plan Management System) filings for Medicare Advantage plan years
• Build and maintain IBNR reserve modeling and support monthly close and financial reporting cycles
• Perform risk adjustment modeling, HCC analysis, and CMS payment reconciliation
• Monitor and respond to CMS data systems including HPMS, MARx, and RAPS/EDPS
• Support RADV audit preparation and encounter data quality review
• Develop and maintain Part D pricing models and support reconciliation processes
• Translate actuarial findings into clear, actionable insights for non-actuarial stakeholders
• Partner cross-functionally with finance, clinical, compliance, and network teams
• Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles

What Success Looks like:

• Successfully support or lead the CMS bid submission cycle
• Deliver accurate, actionable insights from risk and financial modeling
• Strengthen reserve modeling and reporting processes
• Provide clear, executive-ready recommendations

Qualifications:

• Required Qualifications:
• Bachelor's degree in Actuarial Science, Mathematics, Statistics, or related quantitative field
• ASA (Associate of the Society of Actuaries) required
• 5- 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings
• Minimum 2 years of Medicare Advantage health plan experience (required)
• Hands-on experience with CMS bid development and HPMS submissions
• Experience with risk adjustment modeling, HCC analysis, and CMS payment reconciliation
• Advanced proficiency in Excel and actuarial modeling tools
• Experience using SAS, R, Python, or SQL to analyze large healthcare datasets
• Experience working with CMS data systems (HPMS, MARx, RAPS/EDPS)

• Preferred Qualifications:
• FSA and/or MAAA designation
• Experience with ISNP, D-SNP, or dual-eligible populations
• Part D pricing and/or reconciliation experience
• Exposure to RADV audits and encounter data processes