Senior Medicare Actuary — MAPD/PDP EGWP Pricing

Blue Cross and Blue Shield of Kansas Inc.; Chicago (IL); Hybride; USD 128 000 - 185 000; Plein temps

Résumé du poste

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

The role requires expertise in RAF/HCC analytics and bid development for Medicare Advantage and Part D. The ideal candidate will lead actuarial studies, support reserving and forecasting, and communicate results to management and external partners.

Qualifications

• Bachelor's degree or equivalent work experience.
• 7+ years actuarial experience, with Medicare Advantage/Part D or related health insurance exposure.
• ASA and MAAA credentials are required.
• Strong communication and presentation skills; ability to convey complex actuarial concepts to non-technical audiences.

Responsabilités

• Modeling and analysis for EGWP pricing, benefit design, CMS revenue, and risk adjustment.
• Develops and maintains pricing, underwriting, reserving, forecasting and experience monitoring models.
• Lead evaluations of regulatory changes and business initiatives affecting FEP/BCBS plans.
• Present findings to management and external stakeholders; provide technical actuarial support as needed.

Connaissances

Actuarial expertise

Forecasting

Trend analysis

Financial analysis

Programming skills

SAS/SQL/R/VB

Communication skills

Excel proficiency

AI literacy

Formation

Bachelor's degree

Outils

SAS

SQL

R

Visual Basic

Excel

Description du poste

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

The role requires expertise in RAF/HCC analytics and bid development for Medicare Advantage and Part D. The ideal candidate will lead actuarial studies, support reserving and forecasting, and communicate results to management and external partners.