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Associate Actuary, CMS Regulatory & Bid Pricing
Curana Health. Lead CMS bid development and HPMS filing for Medicare Advantage plan years .
Tech Stack
Tools & technologiesPythonSQL
About the role
Key responsibilities & impact- Lead CMS bid development and HPMS filing for Medicare Advantage plan years
- Build and maintain IBNR reserve models; support monthly close and financial reporting
- 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 Part D pricing models and support Part D reconciliation processes
- Translate actuarial findings into clear, actionable insights for non-actuarial audiences
- Partner cross-functionally with finance, clinical, compliance, and network teams
- Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles
Requirements
What you’ll need- Associate of the Society of Actuaries (ASA) required; Fellow (FSA) strongly preferred
- Member of the American Academy of Actuaries (MAAA) preferred
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field
- 5 to 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings
- Minimum 2 years of direct experience working with a Medicare Advantage health plan (required)
- Prior experience with ISNP, D-SNP, or dual-eligible populations strongly preferred
- Hands-on CMS bid development and HPMS filing experience
- Risk adjustment modeling, HCC analysis, and CMS payment reconciliation experience
- Part D pricing and/or reconciliation experience a plus
- Exposure to RADV audit methodology and encounter data quality a plus
- Advanced proficiency in Excel and actuarial modeling tools
- Experience with SAS, R, Python, or SQL for data extraction and analysis
- Familiarity with CMS data systems including HPMS, MARx, and RAPS/EDPS
- Ability to work with large claims datasets and synthesize findings clearly
Benefits
Comp & perks- Health insurance
- 401(k) matching
- Flexible work hours
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
actuarial modelingrisk adjustment modelingHCC analysisCMS payment reconciliationPart D pricingdata extractiondata analysisfinancial reportingIBNR reserve modelsencounter data quality review
Soft Skills
communicationcross-functional collaborationtime managementanalytical thinkingproblem-solving
Certifications
Associate of the Society of Actuaries (ASA)Fellow of the Society of Actuaries (FSA)Member of the American Academy of Actuaries (MAAA)