CMS Actuary: Bid Pricing & Regulatory Insight

Curana Health; United States; On-site; USD 120,000 - 190,000; Full time

Job summary

Curana Health is seeking an experienced Actuary (CMS Regulatory & Bid Pricing) to drive Medicare Advantage bid development and risk adjustment analytics. This senior role combines actuarial rigor with cross-functional collaboration to influence strategic decisions across finance, clinical, and leadership teams.

Remote US-based work supports a national footprint. Ideal candidates have 5-8+ years of healthcare actuarial experience, ASA designation, and hands-on CMS/HPM S submissions, with strong

Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or related quantitative field.
• ASA (Associate of the Society of Actuaries) required.
• 5-8+ years actuary experience, healthcare/managed care preferred.
• Minimum 2 years Medicare Advantage health plan experience.
• Hands-on CMS bid development and HPMS submissions experience.
• Proficiency in Excel and actuarial modeling tools.
• Experience with 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; support monthly close and reporting.
• Perform risk adjustment modeling, HCC analysis, and CMS payment reconciliation.
• Monitor CMS data systems HPMS, MARx, RAPS/EDPS.
• Support RADV audit prep and encounter data quality review.
• Develop and maintain Part D pricing models and reconciliation.
• Translate actuarial findings for non-actuarial stakeholders.
• Partner with finance, clinical, compliance, and network teams.
• Manage multiple deliverables across bid season and CMS cycles.

Skills

Actuarial modeling

CMS bid development

HPMS submissions

Excel

SAS

R

Python

SQL

HCC analysis

Education

Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or related quantitative field

Tools

SAS

R

Python

SQL

Excel

Job description

Curana Health is seeking an experienced Actuary (CMS Regulatory & Bid Pricing) to drive Medicare Advantage bid development and risk adjustment analytics. This senior role combines actuarial rigor with cross-functional collaboration to influence strategic decisions across finance, clinical, and leadership teams.

Remote US-based work supports a national footprint. Ideal candidates have 5-8+ years of healthcare actuarial experience, ASA designation, and hands-on CMS/HPM S submissions, with strong