We are seeking a senior actuary with deep experience in Medicare Part D pricing to join our Government Markets team. This role will have responsibility for the design, development, and ongoing ownership of Part D pricing models, including member-level projections used for forecasting and strategic decision making. Ideal candidates will have hands-on experience with Medicare Part D bid development or prior pharmacy experience.
Key Responsibilities:- Own end-to-end design, development, and maintenance of Part D pricing models to project member-level drug utilization, cost sharing, plan liability, and CMS payments.
- Translate complex Part D benefit designs, formularies, and CMS rules into robust model logic.
- Lead reconciliation of seriatim model results to aggregate bid components, financial forecasts, and statutory reporting.
- Establish modeling standards, validation frameworks, and documentation practices to ensure accuracy and transparency.
- Provide expert judgment on key pricing assumptions, trends, and emerging risks impacting Part D financial performance.
- Lead scenario analysis and strategic modeling (e.g., benefit redesigns, formulary changes, trend, risk mix, regulatory changes, customer level pricing) using seriatim projections.
- Partner closely with finance, pharmacy, underwriting, product, and strategy teams to inform pricing decisions and corporate forecasts.
- Monitor regulatory developments and CMS guidance, assess financial implications, and recommend pricing or strategy responses.
- Present complex modeling results and recommendations to actuarial leadership and senior management.
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related field.
- 6+ years of actuarial experience, with significant focus on Medicare Part D pricing or pharmacy analytics.
- Associate of the Society of Actuaries (ASA) designation.
- Demonstrated experience building, owning, and validating complex actuarial models
- Strong experience working with detailed healthcare claims data.
- Proficiency in Excel and SQL; experience with R, SAS, or similar tools strongly preferred.
- Strong communication skills, with the ability to translate technical results into clear business insights
Preferred Experience:- Direct ownership of Part D bid pricing models or major bid components.
- Experience leading or reviewing seriatim or claim-level actuarial models.
- Demonstrated ability to exercise actuarial judgment in ambiguous or evolving regulatory environments.
- Experience influencing pricing or strategy decisions through data-driven analysis.
- Proven ability to manage multiple high-impact priorities in a deadline-driven environment.
Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
