Part D Actuary

6 days ago

Apply Now

Receive Emails with Similar Jobs

Devoted Health

WebsiteLinkedInAll Job Openings

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

health care • data science • technology • medicare advantage • design

1001 - 5000 employees

Founded 2017

⚕️ Healthcare Insurance

🧘 Wellness

📋 Description

• Develop and refine Part D bid pricing models, ensuring compliance with CMS regulations and competitive market positioning. • Conduct experience analysis, trend forecasting, and risk assessments to optimize financial performance. • Collaborate with finance and product teams to drive strategic pricing decisions and improve overall plan profitability. • Monitor and evaluate CMS regulations, payment methodologies, and risk adjustment impacts related to Part D. • Leverage advanced analytics and actuarial techniques to enhance formulary management and rebate strategies. • Support the development of growth strategies, including expansion into new markets and innovative product designs. • Partner with data science teams to implement predictive modeling and machine learning techniques for enhanced decision-making. • Present key actuarial findings and recommendations to senior leadership and cross-functional stakeholders.

🎯 Requirements

• 10+ years of relevant actuarial experience in healthcare with a deep focus on Medicare Part D plan design • Expert level experience in developing bids as it relates to Part D. • Understanding of the nuances and strategic importance of how each decision affects the overall bid. • In-depth knowledge of CMS bid processes, risk adjustment methodologies, and regulatory requirements. • Strong analytical skills with the ability to interpret complex data and translate insights into actionable strategies. • Excellent communication skills, with experience presenting findings to executive leadership. • A proactive and adaptable mindset, with the ability to thrive in an evolving and entrepreneurial environment. • Broad understanding of managed care business and financial principles such as underwriting, medical management, physician reimbursement, and risk management. • Familiarity with actuarial modeling software (e.g., SAS, SQL, Python, or R) and data visualization tools.

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles • Parental leave program • 401K program • And more....