Remote Medicare Advantage Chief Actuary: Strategy & Pricing

Acturhire; United States; Remote; USD 175,000 - 249,000; Full time

Benefits offered by this job

Medical, Vision and Dental Plans

401k with company match

Paid Time Off (PTO)

Learning and Development Opportunities

Job summary

Lumeris is seeking a seasoned VP, Medicare Advantage Chief Actuary to lead actuarial strategy, pricing, and performance for MA plans. The role drives bid development, risk adjustment, and financial stewardship to sustain margins and strong Star Ratings.

You will partner across Risk Adjustment, Product, Finance, and Operations to optimize plan design and pricing decisions. Remote role with potential for national travel; requires extensive CMS bid and actuarial leadership experience.

Qualifications

• Fellow of the Society of Actuaries (FSA) and MAAA in good standing.
• 15+ years of health actuarial experience with 7–10 years of senior leadership in Medicare Advantage bid preparation, Part C/Part D pricing, reserving, risk adjustment, and financial management.
• Deep knowledge of CMS bid mechanics, HPMS filings, risk adjustment models, and Star Ratings mechanics.
• Excellent communication and leadership skills with track record of delivering results under tight deadlines.

Responsibilities

• Strategic Leadership & Talent Development for the Medicare Advantage actuarial function.
• Executive BI & plan performance analysis for board-level oversight.
• Designs MA product pricing architecture with cross-functional partners.
• Oversees valuation, reserving, pricing, and risk management for plan offerings.
• Leads CMS Part C and Part D bid development, modeling, and submission.
• Guides governance, controls, and audit readiness across actuarial processes.
• Develops innovative methodologies and Star Ratings economics insights.
• Partners with Sales and Growth for market positioning.

Skills

Leadership

Actuarial leadership

Cross-functional collaboration

Education

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

Job description

Lumeris is seeking a seasoned VP, Medicare Advantage Chief Actuary to lead actuarial strategy, pricing, and performance for MA plans. The role drives bid development, risk adjustment, and financial stewardship to sustain margins and strong Star Ratings.

You will partner across Risk Adjustment, Product, Finance, and Operations to optimize plan design and pricing decisions. Remote role with potential for national travel; requires extensive CMS bid and actuarial leadership experience.