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Actuary – CMS Regulatory, Bid Pricing
Curana HealthActuary leading CMS bids, Medicare Advantage pricing, risk adjustment, and regulatory filings for Curana Health’s senior-focused value-based care organization. Partnering with finance, clinical, compliance, and executive teams.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare Advantage bid development, risk adjustment modeling, and financial reporting, with a strong ability to translate complex actuarial findings into actionable insights for diverse stakeholders. Proficient in utilizing advanced actuarial modeling tools and managing multiple deliverables in a fast-paced environment.
Highest-signal resume keywords
Medicare Advantage ExperienceRisk Adjustment ModelingCMS Bid DevelopmentActuarial Modeling ToolsHCC Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Actuarial ScienceStatistical AnalysisFinancial ReportingReserve ModelingData ReconciliationRisk AdjustmentExcel ProficiencySASRPython
Soft Skills
Cross-Functional CollaborationClear CommunicationTime ManagementAnalytical ThinkingProblem Solving
Tools & Technologies
HPMSMARxRAPS/EDPSActuarial Modeling ToolsFinancial Modeling Software
Certifications & Qualifications
ASAFSAMAAA
Industry Keywords
HealthcareManaged CareMedicarePart D PricingRADV Audits
Tech Stack
Tools & technologiesPythonSQL
About the role
Key responsibilities & impact- Lead CMS bid development and HPMS 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
- Support or lead the CMS bid submission cycle
- Deliver accurate, actionable insights from risk and financial modeling
- Strengthen reserve modeling and reporting processes
- Provide clear, executive-ready recommendations
Requirements
What you’ll need- 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
- Minimum 2 years of Medicare Advantage health plan experience required
- Strong preference for healthcare or managed care experience
- 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 including HPMS, MARx, and RAPS/EDPS
- FSA and/or MAAA designation preferred
- Experience with ISNP, D-SNP, or dual-eligible populations preferred
- Part D pricing and/or reconciliation experience preferred
- Exposure to RADV audits and encounter data processes preferred
- Must be able to work in the United States; visa sponsorship is unavailable
Benefits
Comp & perks- Equal Employment Opportunity commitment and nondiscrimination policy
- No visa sponsorship available (H1B or otherwise)