Assistant Actuary I (Medicare)

Independence Blue Cross; Philadelphia (Philadelphia County); Hybrid; USD 80,000 - 100,000; Full time

Job summary

A leading health insurance organization is seeking an experienced Assistant Actuarial I (Medicare) to support pricing, forecasting, and strategic analysis of Medicare products. This role requires 5+ years of actuarial experience with a focus on Medicare pricing and a relevant degree. The candidate will collaborate with cross-functional teams while contributing to compliance and the financial success of government programs. This is a hybrid position based in the Tri-State Area.

Qualifications

• 5+ years of actuarial experience focusing on Medicare pricing.
• Familiarity with CMS bid process and regulatory requirements.
• Demonstrated ability to work independently.

Responsibilities

• Support the development and pricing of Medicare Advantage and Part D products.
• Assist in preparing annual CMS bid submissions.
• Evaluate historical claims and utilization data.

Skills

Medicare pricing

Analytical skills

Proficiency in Excel

SQL

Communication skills

Collaboration

Education

Bachelor’s degree in Actuarial Science, Mathematics, Statistics

Fellow or Associate of the Society of Actuaries (SOA)

Job description

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve.

We are seeking an experienced Assistant Actuarial I (Medicare) professional with a strong background in Medicare pricing to join our Government Markets team. This role is ideal for candidates who have hands-on experience with Medicare Advantage and/or Part D bid development and are looking to apply their expertise in a collaborative, fast-paced environment. The successful candidate will play a key role in supporting the pricing, forecasting, and strategic analysis of our Medicare products, ensuring compliance with CMS requirements and contributing to the financial success of our government programs.

Key Responsibilities

• Support the development and pricing of Medicare Advantage and Part D products.
• Assist in preparing annual CMS bid submissions, including benefit design, cost projections, and revenue estimates.
• Evaluate historical claims and utilization data to support the pricing of benefit differentials and cost-sharing structures across Medicare plan designs.
• Collaborate with cross-functional teams, including finance, underwriting, and product development, in support of pricing analyses and corporate strategy and forecasts.
• Monitor regulatory changes and assess their impact on pricing and profitability.
• Contribute to actuarial models and tools used for bid development and scenario analysis.
• Present findings and recommendations to actuarial leadership and business partners.

Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.
• 5+ years of actuarial experience, with a focus on Medicare pricing.
• Fellow or Associate of the Society of Actuaries (SOA).
• Familiarity with CMS bid process and regulatory requirements.
• Strong analytical and problem-solving skills.
• Proficiency in Excel and SQL.
• Excellent communication and collaboration skills.

Preferred Experience

• Experience with Medicare Advantage and/or Part D actuarial models.
• Understanding of risk adjustment and revenue forecasting.
• Demonstrated ability to work independently and drive projects forward with minimal oversight.

Proven track record of taking initiative, managing competing priorities, and delivering high-quality work in a deadline-driven environment.

Hybrid

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.

Current Associates

Applying for a position? Click here to return to the internal career site. Create and manage profiles for future opportunities, and review prior submissions.

IBX is dedicated to safeguarding what matters most to you. Please protect yourself by staying vigilant against phishing scams involving fake IBX job postings and individuals posing as IBX representatives offering fraudulent job opportunities. What you should know:

• IBX will never request payment of any kind in connection with the hiring or onboarding process.

• IBX will never ask for sensitive personal information, such as your Social Security Number, over the phone or via email.

• Our recruitment process requires job applicants to apply directly through the official application on this site.