Medicare Actuary - MA/PDP Pricing & EGWP Expert

Blue Cross and Blue Shield of Kansas Inc.; Washington (District of Columbia); Hybrid; USD 128,000 - 185,000; Full time

Benefits offered by this job

Annual bonus

Medical/dental/vision insurance

401(k) matching

Paid time off

11 holidays

Job summary

Blue Cross and Blue Shield of Kansas Inc. seeks an experienced Medicare Actuary to perform modeling and analysis for MAPD/PDP EGWP, focusing on pricing, benefit design, CMS revenue, and risk adjustment.

The role supports reserving, forecasting, and experience monitoring with expertise in CMS payment models and RAF/HCC analytics. The candidate will develop, maintain, and communicate actuarial analyses, lead initiatives and respond to technical inquiries from internal and external stakeholders.

Qualifications

• 7+ years actuarial experience, Medicare MA/Part D preferred.
• Expertise in CMS payment models, RAF and HCC analytics.
• Strong communication and presentation skills.

Responsibilities

• Modeling and analysis for MAPD/PDP EGWP pricing and revenue.
• Design benefits, evaluate regulatory changes, monitor experience.
• Lead and communicate actuarial findings to leadership.

Skills

MS Office

Excel

Access

SAS

SQL

Visual Basic

R

Programming

Education

Bachelor's degree

ASA (SOA)

MAAA

Job description

Blue Cross and Blue Shield of Kansas Inc. seeks an experienced Medicare Actuary to perform modeling and analysis for MAPD/PDP EGWP, focusing on pricing, benefit design, CMS revenue, and risk adjustment.

The role supports reserving, forecasting, and experience monitoring with expertise in CMS payment models and RAF/HCC analytics. The candidate will develop, maintain, and communicate actuarial analyses, lead initiatives and respond to technical inquiries from internal and external stakeholders.