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Devoted Health
Devoted Health
1001 – 5000 Darbinieki
LabsajūtaVeselības apdrošināšanaVeselības aprūpe
Devoted Health ir veselības aprūpes un veselības apdrošināšanas uzņēmums, kas koncentrējas uz Medicare Advantage plāniem. Tā piedāvājums apvieno medicīnisko apdrošināšanu ar papildu priekšrocībām, piemēram, zobārstniecības aprūpi, redzes aprūpi, sporta zāles abonementiem un recepšu medikamentiem. Uzņēmums uzsver arī biedru atbalstu, palīdzot viņiem izprast savu apdrošināšanas segumu, pārvaldīt veselības aprūpes vajadzības un izmantot pieejamos pakalpojumus. Devoted Health darbība aptver veselības apdrošināšanu un labbūtību, koncentrējoties uz to, lai priekšrocību izmantošana būtu vienkāršāka un tiktu atbalstītas biedru veselības un finansiālās vajadzības.
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Vakances uzņēmumā

Senior Medicare Advantage Pricing Actuary

Lead Medicare Advantage bid strategy, pricing models, and CMS submissions at Devoted Health. Help improve care for older Americans through data-driven healthcare.

USAmerikas Savienotās Valstis
175 000 $ – 250 000 $ / gads
AttālinātiPilna slodzeVecākais speciālistsVadošais speciālistsNepieciešamā Valoda: angļuAktuārs
PythonSQL

Apraksts

  • Lead the development, modeling, and submission of annual Medicare Advantage Part C and Part D bids.
  • Ensure bids comply with CMS guidance and meet statutory deadlines.
  • Work with product, clinical, and local market leaders to shape competitive benefit packages.
  • Set, support, and document actuarial assumptions for bids.
  • Develop, improve, and maintain scalable bid pricing models.
  • Test scenarios and sensitivities for changes in CMS payment policy, risk models, benchmarks, and competition.
  • Review CMS Call Letters, Bid Instructions, and Rate Announcements, translating updates into model changes and guidance for executives.
  • Coordinate with Finance, Healthcare Economics, Clinical Operations, and Network Management.
  • Work with data engineering and analytics teams to maintain the quality of claims, enrollment, and risk adjustment data.
  • Present bid strategy, financial returns, and risk profiles to executives, board members, and regulatory reviewers.

Prasības

  • At least 8 years of progressive healthcare actuarial experience.
  • At least 5 years focused directly on Medicare Advantage bid pricing, plan design, and CMS bid submissions.
  • A track record of completing complex, time-sensitive projects on schedule.
  • Advanced skills in actuarial modeling, claims data extraction, and financial modeling tools such as SQL, Python, R, SAS, or advanced Excel.
  • Strong knowledge of Medicare Advantage pricing, including Part D direct subsidy and benefit design, CMS-HCC and RxHCC risk adjustment, Star Ratings financial impacts, and benchmark calculations.
  • Excellent interpersonal skills and demonstrated cross-functional collaboration experience.
  • ASA, FSA, or MAAA credentials are optional; equivalent practical expertise and bid leadership experience are recognized.
  • Experience working with reserving, underwriting, risk adjustment operations, or medical economics functions.
  • Ability to work in a fast-paced, high-growth environment.

Priekšrocības

  • Employer-sponsored health, dental, and vision coverage 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.
  • Parental leave program.
  • 401(k) program.

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