Actuary (CMS Regulatory & Bid Pricing)

Curana Health, Inc. • Remote,

4d

About The Position

This opportunity is designed for an Actuary who wants to broaden their impact beyond the numbers. We're seeking someone with a strong actuarial mindset who is curious, business-oriented, and excited to collaborate across functions to solve complex healthcare challenges. At Curana Health, you'll have the opportunity to expand your skill set, influence strategic decisions, and play a meaningful role in innovative initiatives that are helping transform care delivery for the senior population. If you're energized by learning, growth, and making a visible impact, this could be the next step in your career. This is a high-impact opportunity to partner cross-functionally with finance, clinical, compliance, and executive leadership in a rapidly growing, national organization.

Requirements

• 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)

Nice To Haves

• 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

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 This Job Offers

• Job Type: Full-time
• Career Level: Mid Level