Actuarial Analyst II - Medicare job at Blue Cross Blue Shield - BCBS in Philadelphia, PA
Title: Actuarial Analyst II - Medicare Location: Philadelphia United States Job Description: Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve. We are seeking an Actuarial Analyst II - Medicare Pricing professional to join our Government Markets team. This role is ideal for candidates who have hands-on experience with Medicare Advantage and/or Part D bid development and are looking to apply their expertise in a collaborative, fast-paced environment. The successful candidate will play a key role in supporting the pricing, forecasting, and strategic analysis of our Medicare products, ensuring compliance with CMS requirements and contributing to the financial success of our government programs. Key Responsibilities: Support the development and pricing of Medicare Advantage and Part D products. Assist in preparing annual CMS bid submissions, including benefit design, cost projections, and revenue estimates. Evaluate historical claims and utilization data to support the pricing of benefit differentials and cost-sharing structures across Medicare plan designs. Collaborate with cross-functional teams, including finance, underwriting, and product development in support of pricing analyses and corporate strategy, and forecasts. Monitor regulatory changes and assess their impact on pricing and profitability. Contribute to actuarial models and tools used for bid development and scenario analysis. Present findings and recommendations to the actuarial manager. Qualifications: Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related field. 2+ years of actuarial experience, with a focus on Medicare pricing. Completion of four actuarial exams. Familiarity with CMS bid process and regulatory requirements. Strong analytical and problem-solving skills. Proficiency in Excel and SQL. Excellent communication and collaboration skills. Preferred Experience: Experience with Medicare Advantage and/or Part D actuarial models. Demonstrated ability to work independently and drive projects forward with minimal oversight. Proven track record of taking initiative, managing competing priorities, and delivering high-quality work in a deadline-driven environment. Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.