Curana Health

Actuary (CMS Regulatory & Bid Pricing)

Curana Health$110K — $130K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Actuarial Science or related field
  • ASA designation required
  • 5-8+ years of experience in actuarial roles, particularly in healthcare
  • At least 2 years' Medicare Advantage experience
  • Proficient in CMS bid development and HPMS submissions
  • Advanced Excel skills; experience with actuarial modeling tools
  • Familiarity with SAS, R, Python, or SQL for data analysis
  • Experience with CMS data systems like HPMS, MARx, and RAPS/EDPS

Responsibilities

  • Lead development of CMS bid submissions and HPMS filings for Medicare Advantage
  • Build and maintain IBNR reserve models for financial reporting
  • Perform risk adjustment modeling and HCC analysis
  • Respond to and monitor data systems from CMS
  • Support preparation for RADV audits and validate encounter data quality
  • Develop and maintain pricing models for Part D
  • Translate complex actuarial insights for non-actuarial audiences
  • Collaborate with finance, clinical, compliance, and network teams

Benefits

  • Opportunities for growth and skill expansion
  • Cross-functional collaboration
  • High-impact role within a national organization
  • Contributions to innovative healthcare initiatives
  • Involvement in strategic decision-making processes
Full Job Description
Summary

Looking for More Than a Traditional Actuarial Role?

This opportunity is designed for an Actuary who wants to broaden their impact beyond the numbers. We're seeking someone with a strong actuarial mindset who is curious, business-oriented, and excited to collaborate across functions to solve complex healthcare challenges. At Curana Health, you'll have the opportunity to expand your skill set, influence strategic decisions, and play a meaningful role in innovative initiatives that are helping transform care delivery for the senior population. If you're energized by learning, growth, and making a visible impact, this could be the next step in your career. This is a high-impact opportunity to partner cross-functionally with finance, clinical, compliance, and executive leadership in a rapidly growing, national organization.

Essential Duties & Responsibilities

  • Lead CMS (Centers for Medicare & Medicaid Services) bid development and HPMS (Health Plan Management System) filings for Medicare Advantage plan years
  • Build and maintain IBNR reserve modeling and support monthly close and financial reporting cycles
  • Perform risk adjustment modeling, HCC analysis, and CMS payment reconciliation
  • Monitor and respond to CMS data systems including HPMS, MARx, and RAPS/EDPS
  • Support RADV audit preparation and encounter data quality review
  • Develop and maintain Part D pricing models and support reconciliation processes
  • Translate actuarial findings into clear, actionable insights for non-actuarial stakeholders
  • Partner cross-functionally with finance, clinical, compliance, and network teams
  • Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles

What Success Looks like:
  • Successfully support or lead the CMS bid submission cycle
  • Deliver accurate, actionable insights from risk and financial modeling
  • Strengthen reserve modeling and reporting processes
  • Provide clear, executive-ready recommendations


Qualifications

Required Qualifications:
  • Bachelor's degree in Actuarial Science, Mathematics, Statistics, or related quantitative field
  • ASA (Associate of the Society of Actuaries) required
  • 5- 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings
  • Minimum 2 years of Medicare Advantage health plan experience (required)
  • Hands-on experience with CMS bid development and HPMS submissions
  • Experience with risk adjustment modeling, HCC analysis, and CMS payment reconciliation
  • Advanced proficiency in Excel and actuarial modeling tools
  • Experience using SAS, R, Python, or SQL to analyze large healthcare datasets
  • Experience working with CMS data systems (HPMS, MARx, RAPS/EDPS)

Preferred Qualifications:
  • FSA and/or MAAA designation
  • Experience with ISNP, D-SNP, or dual-eligible populations
  • Part D pricing and/or reconciliation experience
  • Exposure to RADV audits and encounter data processes

About Curana Health

Curana Health Careers

There has never been a more opportune time to join Curana Health, a leader in the healthcare industry, renowned for innovation and commitment to enhancing patient care. Curana Health offers a variety of job opportunities that cater to a diverse range of skills and professional interests.

Work You'll Do

At Curana Health, the team is dedicated to transforming healthcare through outstanding service, cutting-edge technology, and accessible treatment. Joining Curana Health means being part of a culture that values diversity and leadership, fostering an environment where every team member is empowered to contribute to their full potential.

Explore Curana Health's Employment Opportunities

Curana Health is building a robust team to drive growth and innovation in healthcare. The company offers positions that challenge individuals to master their professional skills while contributing to meaningful projects that make a real difference.

Engage in Innovative Work

Curana Health is home to a wide array of professionals, from clinical experts to technology enthusiasts, all collaborating to push the boundaries of what's possible in healthcare. The company is a place where innovation meets practical application, creating a dynamic work environment.

Experience Professional Growth and Development

Curana Health is committed to the professional growth of its employees, offering unparalleled opportunities for career advancement and personal development. Whether through leadership training, diversity initiatives, or continuing education, team members at Curana Health have access to the tools they need to succeed.

Benefits of Joining Curana Health

Employees at Curana Health enjoy a comprehensive benefits package that supports both their professional and personal lives. From health and wellness programs to competitive retirement plans, Curana Health invests in its team's well-being.

Internship Programs

Curana Health's internship programs offer a springboard for those beginning their careers, providing hands-on experience in a supportive and challenging environment. Interns gain valuable industry knowledge and networking opportunities that are integral to their professional journey.

Join the Curana Health Team

Curana Health is actively hiring and looking for individuals who are passionate, curious, and driven to excel. Explore open positions that match your skills and interests on the Curana Health Careers page. Prepare your resume, sharpen your interview skills, and take the first step towards a rewarding career at Curana Health.

Stay Connected with Curana Health Jobs

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Learn more about Curana Health
Size
501 employees
Industry

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