Curana Health Logo

Curana Health

Actuary (CMS Regulatory & Bid Pricing)

Posted One Month Ago
Be an Early Applicant
Remote
Hiring Remotely in US
Senior level
Remote
Hiring Remotely in US
Senior level
Leads Medicare Advantage actuarial work, including CMS bid development, HPMS filings, reserve modeling, risk adjustment, HCC analysis, payment reconciliation, Part D pricing, and RADV audit support. The role analyzes healthcare data, monitors CMS systems, translates actuarial findings for executives, and collaborates with finance, clinical, compliance, and network teams.
The summary above was generated by AI
 

At Curana Health, we’re on a mission to radically improve the health, happiness, and dignity of older adults—and we’re looking for passionate people to help us do it.


As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities.


Founded in 2021, we’ve grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for.


If you’re looking to make a meaningful impact on the senior healthcare landscape, you’re in the right place—and we look forward to working with you.


For more information about our company, visit CuranaHealth.com

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

Similar Jobs

6 Minutes Ago
Remote or Hybrid
108K-203K Annually
Senior level
108K-203K Annually
Senior level
eCommerce • Fintech • Hardware • Payments • Software • Financial Services
The Strategic Account Manager is responsible for managing relationships with key Food & Beverage sellers, driving revenue growth through account management, providing technical solutions, and collaborating with cross-functional teams.
Top Skills: Commerce TechnologyTechnical Solutions
56 Minutes Ago
Remote or Hybrid
CA, USA
238K-322K Annually
Senior level
238K-322K Annually
Senior level
Artificial Intelligence • Cloud • Information Technology • Sales • Security • Software • Cybersecurity
Set the technical direction for Rapid7’s LLM and agentic AI systems. Lead architecture, model strategy, fine-tuning, post-training, inference optimization, evaluation standards, and complex cross-team initiatives. Build critical model and inference code, mentor senior engineers, resolve technical trade-offs, and influence product and platform strategy across cybersecurity products.
Top Skills: Agentic AiAWSClassical Machine LearningCudaDeepspeedDistributed TrainingDpoFsdpGrpoLlmsLoraPredictive AiPythonPyTorchQloraSglangTensorrt-LlmTransformer ArchitectureTritonVllm
56 Minutes Ago
Easy Apply
Remote
United States
Easy Apply
44K-70K Annually
Junior
44K-70K Annually
Junior
Big Data • Fintech • Mobile • Payments • Financial Services
Resolves escalated customer inquiries through email and occasional phone support, applying product and financial knowledge to investigate complex issues. Maintains quality and productivity standards, identifies process improvements, supports training and new product launches, collaborates cross-functionally, manages schedules and channels, and creates procedural documentation. Requires English and French proficiency, strong communication, judgment, organization, and customer service experience in an omnichannel environment.
Top Skills: Google WorkspaceMac (Ios)

What you need to know about the Colorado Tech Scene

With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.

Key Facts About Colorado Tech

  • Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
  • Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
  • Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
  • Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
  • Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account