Curana Health Logo

Curana Health

Actuary (CMS Regulatory & Bid Pricing)

Posted Yesterday
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

47 Seconds Ago
Remote or Hybrid
127K-159K Annually
Senior level
127K-159K Annually
Senior level
Digital Media • eCommerce • Gaming • Mobile • News + Entertainment
Lead finance data governance, quality validation, reconciliation, SOX control execution, audit support, and finance-system integration initiatives. Define data standards, lineage, controls, and validation criteria across ERP, subledger, reporting, and interface environments. Partner with Accounting, Finance, Technology, and business teams on requirements, testing, cutover, defect resolution, change management, and post-production validation to ensure accurate, complete, traceable, and reliable financial data.
Top Skills: APIsConcurCoupaErp SystemsNetSuiteOracleSAPSQL
10 Minutes Ago
Remote
United States
397K-655K Annually
Expert/Leader
397K-655K Annually
Expert/Leader
Artificial Intelligence • HR Tech • Information Technology • Software • Business Intelligence
Executive sales leader responsible for developing and executing Qualtrics’ US healthcare go-to-market strategy, driving enterprise SaaS revenue growth, expanding health system, payer, and life sciences relationships, and leading a 150+ person sales organization. The role oversees complex multi-buyer sales cycles, partner ecosystems, forecasting, pipeline rigor, executive negotiations, talent development, and cross-functional collaboration to shape healthcare product strategy and increase platform adoption.
Top Skills: CahpsHcahpsHipaaHitechQualtrics Experience Management (Xm) PlatformSaaS
10 Minutes Ago
Remote or Hybrid
AZ, USA
Senior level
Senior level
Financial Services
Leads compliance and operational risk testing strategies across business lines. Oversees control assessments, identifies gaps, verifies effectiveness, drives remediation, manages complex testing initiatives, and communicates outcomes to senior stakeholders and regulators. The role also manages a diverse team and ensures alignment with firm policies and regulatory requirements.

What you need to know about the Seattle Tech Scene

Home to tech titans like Microsoft and Amazon, Seattle punches far above its weight in innovation. But its surrounding mountains, sprinkled with world-famous hiking trails and climbing routes, make the city a destination for outdoorsy types as well. Established as a logging town before shifting to shipbuilding and logistics, the Emerald City is now known for its contributions to aerospace, software, biotech and cloud computing. And its status as a thriving tech ecosystem is attracting out-of-town companies looking to establish new tech and engineering hubs.

Key Facts About Seattle Tech

  • Number of Tech Workers: 287,000; 13% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Amazon, Microsoft, Meta, Google
  • Key Industries: Artificial intelligence, cloud computing, software, biotechnology, game development
  • Funding Landscape: $3.1 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Madrona, Fuse, Tola, Maveron
  • Research Centers and Universities: University of Washington, Seattle University, Seattle Pacific University, Allen Institute for Brain Science, Bill & Melinda Gates Foundation, Seattle Children’s Research Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account