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

9 Minutes Ago
Remote or Hybrid
129K-256K Annually
Senior level
129K-256K Annually
Senior level
Cloud • Software
Design and build scalable, secure cloud-native platform components for ThousandEyes. Develop Java applications, event-driven systems, data pipelines, real-time enrichments, and microservices. Collaborate with product and engineering teams on planning, integration, prototypes, architecture, and implementation. Mentor junior engineers, conduct design reviews, and help ensure reliable services meet SLA targets while supporting significant platform growth.
Top Skills: Amazon SnsAmazon SqsAWSAzureDockerGCPGradleJavaJvmKafkaKotlinKubernetesMavenMicroservicesNoSQLScalaSQL
12 Minutes Ago
In-Office or Remote
United States
105K-250K Annually
Junior
105K-250K Annually
Junior
Digital Media • Fintech • Information Technology • Machine Learning • Financial Services • Cybersecurity • Automation
Develop and manage a branch-based wealth management practice by conducting client discoveries, creating tailored financial plans, driving new business development and referrals, conducting proactive outreach, and coordinating with internal specialists for investment, insurance, estate, and financial planning services.
21 Minutes Ago
Easy Apply
Remote or Hybrid
Easy Apply
80K-125K Annually
Senior level
80K-125K Annually
Senior level
Artificial Intelligence • Marketing Tech • Software
Owns end-to-end client implementations for Movable Ink’s personalization platforms. Manages launch projects, develops implementation plans, configures and QA-tests campaigns, designs technical solutions, trains clients, troubleshoots issues, and coordinates with developers, engineers, architects, product teams, and stakeholders to achieve client goals and KPIs.
Top Skills: APIsCloud Data WarehousesData LakesEmail Service ProvidersETLHTMLJavaScriptMmsMovable Ink Da VinciMovable Ink StudioPush MessagingSms

What you need to know about the Los Angeles Tech Scene

Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.

Key Facts About Los Angeles Tech

  • Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
  • Key Industries: Artificial intelligence, adtech, media, software, game development
  • Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
  • Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account