Director and Part D Actuary

Posted 8 Days Ago
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Hiring Remotely in USA
Remote
Senior level
Healthtech
The Role
The Part D Actuary at Devoted Health will manage pricing, forecasting, and strategic decisions related to Medicare Advantage Prescription Drug products. Responsibilities include developing bid pricing models, conducting financial analysis, collaborating with product teams, and presenting findings to leadership.
Summary Generated by Built In

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit about this role: 

We are seeking a highly skilled and motivated Part D Actuary to support our Medicare Advantage Prescription Drug (MAPD) business. This individual will play a critical role in pricing, forecasting, and strategic decision-making for our Part D products. The ideal candidate thrives in a fast-paced, dynamic environment and is eager to make a meaningful impact at Devoted Health.   This role will play an integral part in  our annual plan bid and will collaborate regularly with our executive team as well as market leadership, to improve the strategic thinking of product design. This leadership position will report to our Chief Actuary. 

Required skills and experience: 

  • 10+ years of relevant actuarial experience in healthcare with a deep focus on Medicare Part D plan design

  • Expert level experience in developing bids as it relates to Part D. Understanding of the nuances and strategic importance of how each decision affects the overall bid.

  • In-depth knowledge of CMS bid processes, risk adjustment methodologies, and regulatory requirements.

  • Strong analytical skills with the ability to interpret complex data and translate insights into actionable strategies.

  • Excellent communication skills, with experience presenting findings to executive leadership.

  • A proactive and adaptable mindset, with the ability to thrive in an evolving and entrepreneurial environment.

  • Broad understanding of managed care business and financial principles such as underwriting, medical management, physician reimbursement, and risk management. 

  • Familiarity with actuarial modeling software (e.g., SAS, SQL, Python, or R) and data visualization tools.

Desired skills and experience: 

  • ASA or FSA designation from the Society of Actuaries, with strong progress toward or completion of MAAA.

  • Experience in actuarial valuation, specifically the preparation and analysis of financial statements, actuarial opinion, and actuarial memorandum. 

Your Responsibilities and Impact will include: 

  • Develop and refine Part D bid pricing models, ensuring compliance with CMS regulations and competitive market positioning.

  • Conduct experience analysis, trend forecasting, and risk assessments to optimize financial performance.

  • Collaborate with finance and product teams to drive strategic pricing decisions and improve overall plan profitability.

  • Monitor and evaluate CMS regulations, payment methodologies, and risk adjustment impacts related to Part D.

  • Leverage advanced analytics and actuarial techniques to enhance formulary management and rebate strategies.

  • Support the development of growth strategies, including expansion into new markets and innovative product designs.

  • Partner with data science teams to implement predictive modeling and machine learning techniques for enhanced decision-making.

  • Present key actuarial findings and recommendations to senior leadership and cross-functional stakeholders.
    Salary range: Commensurate with experience
    #LI-Remote

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Top Skills

Actuarial Modeling Software
Data Visualization Tools
Python
R
SAS
SQL
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The Company
HQ: Waltham, MA
1,120 Employees
On-site Workplace
Year Founded: 2017

What We Do

Devoted Health is a new healthcare company serving seniors. Our mission is to dramatically improve the health and well-being of older Americans by caring for each and every person like they are family. We are devoted to the health and wellness of our members by helping them navigate the healthcare system with personal guides, by utilizing world-class technology to enable a simplified experience, and by partnering with top providers for better health outcomes.

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