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Devoted Health
Devoted Health
1.001 – 5.000 Angajați
Asigurare de sănătateAsistență medicalăStare de bine
Devoted Health este o companie de servicii medicale și asigurări de sănătate axată pe planurile Medicare Advantage. Ofertele sale combină acoperirea medicală cu beneficii suplimentare, precum îngrijirea dentară, ochelarii, abonamentele la săli de sport și medicamentele eliberate pe bază de rețetă. Compania pune, de asemenea, accent pe sprijinirea membrilor, ajutându-i să își înțeleagă acoperirea, să își gestioneze nevoile de sănătate și să acceseze serviciile disponibile. Activitatea Devoted Health acoperă domeniile asigurărilor de sănătate și bunăstării, cu accent pe facilitarea utilizării beneficiilor și pe sprijinirea nevoilor de sănătate și financiare ale membrilor.
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Locurile de muncă ale companiei

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.

USStatele Unite ale Americii
175.000 $ – 250.000 $ / an
RemoteNormă întreagăSeniorLiderLimbă Obligatorie: englezăActuar
PythonSQL

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

  • 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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