Medicare Actuary

Jobtailor; Illinois; Hybrid; USD 110,000 - 165,000; Full time

Job summary

Jobtailor is seeking an experienced Actuary to lead Medicare Part D financial modeling, forecasting, and reserves. You will own the monthly close components, support Part D settlements, and help shape Medicare Advantage bids.

You will build advanced models on large healthcare datasets, identify automation opportunities, and mentor junior staff while communicating complex concepts to senior leadership.

Qualifications

• 4+ years actuarial experience in healthcare.
• Medicare Advantage experience required, including Part D.
• Near-ASA with ASA strongly preferred.
• Experience supporting monthly close processes, reserving, forecasting, and Part D settlement modeling.
• Advanced Microsoft Excel skills and proficiency in the Microsoft Office Suite.
• Experience with SQL and healthcare data extraction and manipulation.
• Strong analytical thinking, problem‑solving, and critical reasoning skills.
• Ability to work independently, exercise sound judgment, and manage multiple priorities with minimal supervision.
• Strong verbal and written communication skills with a demonstrated ability to effectively present financial and actuarial concepts to both technical and non‑technical audiences.
• Legal authorization to work in the United States without employer sponsorship.

Responsibilities

• Lead development, maintenance, and enhancement of Medicare Part D financial models (settlements, forecasting, experience monitoring).
• Own actuarial components of the monthly close process, including evaluation of IBNR reserves.
• Contribute to the development and submission of Medicare Advantage bids.
• Build actuarial models and perform complex data analysis using large healthcare datasets to support forecasting, reserving, and strategic decision‑making.
• Identify opportunities to improve existing processes, automate workflows, and enhance analytical capabilities.
• Serve as a subject matter expert for Medicare Advantage and Part D financial analyses.
• Present findings, recommendations, and actuarial concepts to senior leadership clearly.
• Mentor and support junior actuarial team members through technical guidance and knowledge sharing, while not having direct people management responsibilities.

Skills

Actuarial experience

Medicare Advantage

Part D experience

SQL

Excel

Data analysis

Communication skills

Independent work

Problem solving

Mentoring

Education

Near-ASA

ASA

Tools

SQL

Job description

Responsibilities

• Lead the development, maintenance, and ongoing enhancement of Medicare Part D financial models, including settlements, forecasting, and experience monitoring.
• Own actuarial components of the monthly close process, including evaluation of IBNR reserves.
• Contribute to the development and submission of Medicare Advantage bids.
• Build actuarial models and perform complex data analysis using large healthcare datasets to support forecasting, reserving, and strategic decision‑making.
• Identify opportunities to improve existing processes, automate workflows, and enhance analytical capabilities.
• Serve as a subject matter expert for Medicare Advantage and Part D‑related financial analyses.
• Present findings, recommendations, and actuarial concepts to senior leadership in a clear and concise manner.
• Mentor and support junior actuarial team members through technical guidance and knowledge sharing, while not having direct people management responsibilities.

Requirements

• 4+ years of actuarial experience in a healthcare environment.
• Medicare Advantage experience required, including Part D experience.
• Near‑ASA (Associate of the Society of Actuaries) with ASA strongly preferred.
• Experience supporting monthly close processes, reserving, forecasting, and Part D settlement modeling.
• Advanced Microsoft Excel skills and proficiency in the Microsoft Office Suite.
• Experience with SQL and healthcare data extraction and manipulation.
• Strong analytical thinking, problem‑solving, and critical reasoning skills.
• Ability to work independently, exercise sound judgment, and manage multiple priorities with minimal supervision.
• Strong verbal and written communication skills with a demonstrated ability to effectively present financial and actuarial concepts to both technical and non‑technical audiences.
• Legal authorization to work in the United States without employer sponsorship.

Core Competencies

Demonstrates expertise in Medicare Advantage and Part D financial modeling, including settlements and forecasting, while leveraging advanced analytical skills to support strategic decision‑making. Proficient in mentoring junior team members and presenting complex actuarial concepts to diverse audiences.

Certifications & Qualifications

• Near‑ASA
• ASA