Our client, a leading healthcare organization, is seeking an Actuary, Medicare to join their team. This role focuses on supporting payer partnerships, developing actuarial models, and evaluating financial risks and opportunities in the Medicare Advantage (MA) space.
Responsibilities:
- Conduct financial forecasting and provide actionable insights.
- Develop and assist bid submissions on the payer side.
- Assess and refine accrual models and risk adjustment predictions.
- Identify opportunities for cost reduction and operational efficiency.
- Analyze healthcare utilization trends and collaborate with medical management.
- Stay updated on market developments and regulatory changes.
- Work closely with leadership and key departments to align actuarial strategies.
Requirements:
- Bachelor's degree required
- ASA designation preferred
- 5-10 years of actuarial experience, preferably in MA bid submissions (Part C & Part D).
- Experience with provider payment systems and payer contracts.
- Proficiency in data analytics tools (VBA, SQL, PowerBI, etc.).
- Strong skills in Microsoft Office and Google Suite.
