Managing Consulting Actuary

A leading actuarial and healthcare consulting firm is seeking a Senior Consulting Actuary to support Medicare Part D and Medicare Advantage clients across pricing, bid development, forecasting, and regulatory strategy. This individual will serve as a key advisor to health plans, helping clients navigate the evolving Medicare landscape while developing competitive and financially sound Part D pricing strategies.

The ideal candidate will possess deep expertise in Medicare Part D bid development, pricing methodologies, CMS regulations, forecasting, and financial modeling. This role offers significant client exposure and the opportunity to influence strategic decision-making for some of the nation's leading health plans.

• Lead Medicare Part D and MAPD bid development projects for health plan clients.
• Develop and review key bid assumptions including trend, formulary, membership, risk scores, rebates, low-income subsidy impacts, and benefit changes.
• Perform pricing analyses, financial forecasting, and profitability assessments to support bidding strategies.
• Advise clients on Medicare regulatory changes, CMS guidance, Inflation Reduction Act impacts, and emerging market trends.
• Support bid desk reviews, CMS audit requests, and annual bid submission processes.
• Conduct competitive market analyses and recommend strategies to improve pricing performance and member value.
• Partner with pharmacy, clinical, finance, product, and underwriting teams to develop integrated pricing solutions.
• Build and enhance actuarial models used for Medicare pricing, forecasting, and scenario testing.
• Present findings and strategic recommendations to client executives and senior stakeholders.
• Mentor junior consultants and provide technical oversight on actuarial deliverables.
• Contribute to business development initiatives and cultivate long-term client relationships.

Qualifications

• ASA or FSA designation; MAAA preferred.
• 5+ years of actuarial experience with a focus on Medicare Advantage and/or Medicare Part D.
• Direct experience supporting Medicare Part D bid development and pricing.
• Strong understanding of CMS bid requirements, formulary design, risk adjustment, rebates, and Medicare regulations.
• Experience working with Medicare bid assumptions, forecasting models, and financial projections.
• Proven ability to communicate complex actuarial concepts to non-technical stakeholders.
• Advanced Excel skills required; experience with SQL, SAS, Python, R, or actuarial modeling tools preferred.
• Prior consulting experience or significant client-facing experience is highly desirable.

Preferred Experience

• Medicare Part D bid strategy and pricing optimization.
• CMS bid audits, desk reviews, and regulatory compliance.
• MAPD/PDP product development and benefit design.
• Pharmacy trend analysis, rebate forecasting, and formulary evaluations.
• Financial forecasting, budgeting, and long-range strategic planning.
• Leadership of actuarial projects and mentoring of junior staff.