Actuary: CMS Bid & Risk Modeling Specialist

Curana Health; Idaho; On-site; USD 120,000 - 180,000; Full time

Job summary

Curana Health is seeking a senior actuary to broaden impact beyond the numbers. You’ll lead CMS bid development, risk-adjustment modeling, and Part D pricing tasks while collaborating with finance, clinical, and leadership teams across a national platform.

Ideal candidates bring 5+ years of actuarial experience in healthcare, ASA certification, and strong skills in Excel, SAS, R, Python, and SQL. This role offers growth, visibility, and critical contributions to senior care delivery nationwide.

Qualifications

• 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, healthcare or managed care settings preferred.
• Minimum 2 years of Medicare Advantage health plan experience (required).
• 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 CMS data systems (HPMS, MARx, RAPS/EDPS).

Responsibilities

• 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.

Skills

Analytical thinking

Healthcare actuarial experience

Medicare Advantage experience

Cross-functional collaboration

Excel modeling

Education

Bachelor's degree in Actuarial Science/related field

ASA designation

Tools

SAS

R

Python

SQL

Excel

HPMS

MARx

RAPS/EDPS

CMS bid development

Job description

Curana Health is seeking a senior actuary to broaden impact beyond the numbers. You’ll lead CMS bid development, risk-adjustment modeling, and Part D pricing tasks while collaborating with finance, clinical, and leadership teams across a national platform.

Ideal candidates bring 5+ years of actuarial experience in healthcare, ASA certification, and strong skills in Excel, SAS, R, Python, and SQL. This role offers growth, visibility, and critical contributions to senior care delivery nationwide.