Pricing Actuary-Medicare Advantage

Devoted Health • Waltham, MA

1d • $175,000 - $250,000 • Remote

About The Position

The Pricing Actuary is an actuarial leader responsible for directing the strategy, modeling, and execution of the annual Medicare Advantage bidding process, including Part C and Part D bids. The role requires deep experience in Medicare Advantage bid preparation, rate cell modeling, CMS regulations, and risk adjustment mechanics, alongside strong operational execution to meet regulatory deadlines and bring consistency to complex financial cycles.

The Pricing Actuary develops bid assumptions and pricing models, evaluates product and benefit options, assesses the effects of regulatory and market changes, and partners with teams across the organization to ensure bid assumptions reflect operational capabilities and reliable data. The role also presents bid strategy, financial returns, and risk profiles to executive leadership, board members, and regulatory reviewers.

Devoted Health is a healthcare company founded in 2017, focused on improving the health and well-being of older Americans through an integrated care platform combining data and AI with clinical and service experiences. The position is remote. The posted salary range is $175,000–$250,000 per year, with actual pay dependent on relevant qualifications and other factors.

Requirements

• At least 8 years of progressive healthcare actuarial experience, including at least 5 years of direct Medicare Advantage bid pricing, plan design, and CMS bid submission experience.
• Demonstrated ability to complete complex, time-sensitive projects on schedule and manage high-stakes regulatory deadlines with precision.
• Advanced proficiency in actuarial modeling, claims data extraction, and financial modeling tools such as SQL, Python, R, SAS, or advanced Excel modeling.
• Thorough understanding of Medicare Advantage pricing mechanics, including Part D direct subsidy and benefit design, CMS-HCC and RxHCC risk adjustment models, Star Ratings financial impacts, and benchmark calculations.
• Exceptional interpersonal and collaborative skills, including the ability to explain complex actuarial concepts as clear strategic choices for non-actuarial partners.

Nice To Haves

• Associate or Fellow of the Society of Actuaries (ASA or FSA) and Member of the American Academy of Actuaries (MAAA); equivalent practical mastery and bid leadership experience are also considered.
• Experience interfacing with reserving, underwriting, risk adjustment operations, or medical economics functions.
• Comfort working in a fast-paced, high-growth environment where processes are continuously refined and optimized.

Responsibilities

• Direct and oversee the end-to-end development, modeling, and submission of annual Medicare Advantage Part C and Part D bids, ensuring CMS compliance and adherence to statutory deadlines.
• Partner with product, clinical, and local market leaders to design competitive benefit packages and evaluate product trade-offs, supplemental benefits, and cost-sharing against financial and growth targets.
• Establish, defend, and document actuarial bid assumptions, including baseline utilization, unit cost trends, risk adjustment factors, administrative expense allocations, and margin targets.
• Build, refine, and maintain scalable bid pricing models with strong technical accuracy, model governance, and repeatable execution across markets.
• Perform scenario testing and sensitivity analyses to quantify the financial impacts of CMS payment policy changes, risk model updates, benchmark shifts, and competitive market dynamics.
• Interpret CMS Call Letters, Bid Instructions, and Rate Announcements and translate regulatory changes into modeling adjustments and executive guidance.
• Collaborate with Finance, Healthcare Economics, Clinical Operations, and Network Management so bid assumptions reflect operational capabilities, clinical programs, and provider contracting terms.
• Partner with data engineering and analytics teams to ensure historical claims, enrollment, and risk adjustment data used in bid models is complete and accurate.
• Prepare executive-level presentations on bid strategy, financial returns, and risk profiles for executive leadership, board members, and regulatory reviewers.

Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Bonus eligibility for roles below Director level; Sales roles are eligible for commission.
• Parental leave program.
• 401(k) program.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed