Senior Actuarial Analyst, Medicare Bid - Switch4 LLC

Key Details:

• This position is affiliated with the Health Plan and will be tied to a location and compensation range in Portland, Oregon.
• Remote work is available for residents in the following states:
  • Washington
  • Oregon
  • California

Position Summary:
The Senior Actuarial Analyst, Medicare Bid will be responsible for developing and maintaining actuarial models, analyzing data, and providing strategic insights to support the pricing and bidding process for Medicare Advantage plans. This role requires a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical background. The Senior Actuarial Analyst will play a key role in developing and executing pricing strategies, ensuring compliance with regulatory guidelines, and providing critical insights to enhance the performance of Medicare Advantage plans.

Responsibilities:

• Develop and implement bid pricing strategies, ensuring analytical rigor and speed for assessing the impact of product design on the financial performance of Medicare Advantage plans.
• Analyze and interpret regulatory guidance to ensure compliance with Medicare Advantage bid requirements.
• Collaborate with product, market, executive, and other cross-functional teams to incorporate market trends, competitive analysis, and organizational goals into pricing decisions.
• Develop key inputs and assumptions in support of the annual Medicare Advantage bid.
• Conduct sensitivity analyses and scenario testing to assess the impact of various factors on bid pricing outcomes.
• Analyze healthcare claims data, enrollment data, and other relevant information to identify trends and patterns.
• Work closely with data analysts and actuaries to ensure the accuracy and completeness of data used in the pricing process.
• Stay informed of changes in risk adjustment methodologies and assess their implications for pricing and financial performance.
• Generate regular reports for senior management, highlighting key performance indicators and providing insights into financial results.
• Analyze large datasets to identify trends, patterns, and areas for improvement in pricing methodologies.

Required Qualifications:

• Bachelor's Degree in Statistics, Mathematics, Actuarial Science, Finance, or a related field.
• 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:

• 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.