Title: Manager/Senior Manager: Medicare Advantage
Locations: Hybrid (3 times per week) – Atlanta, Boston, Philadelphia, Tampa, San Francisco, Milwaukee, Washington D.C., & Chicago.
Comp: $150-200k + bonus
Type: Full-Time Opportunity
As a Senior Manager, you will lead multiple workstreams on projects for major health insurers and provider systems, ensuring high-quality delivery and strong client engagement. You’ll guide and mentor team members, supporting their professional development while managing complex workflows. This health consulting group is rapidly expanding, fostering a collaborative culture that values fresh ideas, diversity, and challenging the status quo, with opportunities to work on innovative and impactful projects.
**Only those who do not require any current or future sponsorship can be considered, no 3rd parties**
Potential Responsibilities
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Take ownership of Medicare Advantage bid submissions for both Part C and Part D, including certification.
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Contribute to the development, modeling, and pricing of health insurance products within the Medicare Advantage market.
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Establish pricing assumptions, methodologies, and trend factors to ensure accuracy and competitiveness.
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Conduct detailed analysis of medical and pharmacy claims, including benchmarking against industry norms.
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Perform feasibility assessments for new market entries, product launches, or payer-provider collaborations.
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Provide support for the interpretation and implementation of regulatory updates.
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Evaluate provider contracts and assess the financial impact of proposed changes.
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Analyze value-based care initiatives and other risk-sharing models from both payer and provider perspectives.
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Identify opportunities to improve total cost of care and enhance population health outcomes.
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Review risk scores and support initiatives to strengthen coding accuracy and risk capture.
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Assess care management programs and their effectiveness.
Qualifications & Skills
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Bachelor’s or Master’s degree in Actuarial Science, Mathematics, Statistics, Finance, or a related discipline.
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At least 7 years of actuarial experience, specifically within the Medicare Advantage space (consulting experience strongly preferred).
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Credentialed Associate (ASA) or Fellow (FSA) of the Society of Actuaries.
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Proven ability to manage complex, medium-to-large projects with limited oversight from senior leadership.
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Demonstrated ability to learn quickly, perform at a high level, and continue professional development.
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Excellent verbal and written communication skills.
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Strong organizational and time management abilities with the capacity to handle multiple priorities.
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Collaborative mindset with the ability to work effectively across diverse teams.
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Strong problem-solving and critical-thinking skills, with a proactive and motivated approach.
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Technical expertise in tools such as Excel, SAS, SQL, R, Python, VBA, or other programming languages.
To be considered for the role please apply online or email an updated resume to Samuel Wallen at Oiver James: [email protected]
