SENIOR ACTUARIAL ANALYST, MEDICARE BID *REMOTE* - 334926

Job Description

Our clients hospital's Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. 

Our clients hospital's Health Plan is calling a Senior Actuarial Analyst, Medicare Bid who will:

• 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

This position is affiliated with the hospital's Health Plan and will be tied to a location and compensation range in Portland, Oregon

our Health Plan welcomes remote work for residents who reside in one of the following states:

1. Washington
2. Oregon
3. California

Responsibilities may include:

• 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 for this position include:

• 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 for this position include:

• 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