Position Overview: As a Senior Manager Actuary specializing in Medicare Bids at a leading consulting firm, you will play a pivotal role in providing actuarial leadership and strategic guidance to healthcare clients seeking to maximize their Medicare Advantage programs. Your expertise will be instrumental in ensuring clients' Medicare Bid submissions are competitive, compliant, and financially sound.
Key Responsibilities:
- Medicare Bid Strategy: Develop and execute comprehensive Medicare Bid strategies, leveraging your actuarial expertise to optimize reimbursement rates, risk adjustment, and revenue for clients.
- Client Engagement: Serve as the lead actuary and primary point of contact for clients, building and maintaining strong relationships. Understand clients' unique objectives and tailor actuarial solutions accordingly.
- Bid Analysis and Optimization: Conduct rigorous actuarial analysis of Medicare Bids, identifying opportunities for cost reduction, revenue enhancement, and risk management. Implement data-driven optimization strategies.
- Regulatory Compliance: Stay current with CMS regulations and guidelines related to Medicare Bids. Ensure that clients' Bid submissions adhere to all compliance requirements and provide guidance on risk mitigation.
- Reporting and Presentation: Prepare and deliver clear and insightful actuarial reports and presentations to clients, effectively communicating complex actuarial concepts and recommendations.
Qualifications:
- FSA or ASA designation
- A minimum of 9 years of experience in healthcare actuarial consulting, with a strong focus on Medicare Bids.
- In-depth knowledge of Medicare Advantage, Part D, and ACOs.
- Extensive experience with actuarial modeling, data analysis, and risk assessment.
