Associate Actuary (CMS Regulatory & Bid Pricing)

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

Curana Health is seeking an experienced Health Plan Actuary to support critical financial, regulatory, and analytical functions across our Medicare Advantage lines of business. 

The ideal candidate brings deep technical expertise in healthcare actuarial science and the ability to communicate complex findings to finance, clinical, and executive stakeholders. You will play a central role in CMS bid development, risk adjustment strategy, reserve modeling, and regulatory compliance at a company with over 2,400 employees and significant growth momentum.

Essential Duties & Responsibilities

Lead CMS bid development and HPMS filing for Medicare Advantage plan years

Build and maintain IBNR reserve models; support monthly close and financial reporting

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 Part D pricing models and support Part D reconciliation processes

Translate actuarial findings into clear, actionable insights for non-actuarial audiences

Partner cross-functionally with finance, clinical, compliance, and network teams

Manage multiple deliverables across competing deadlines including bid season and CMS filing cycles

Qualifications

Credentials & Education

Associate of the Society of Actuaries (ASA) required; Fellow (FSA) strongly preferred

Member of the American Academy of Actuaries (MAAA) preferred

Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field

Experience

5 to 8+ years of actuarial experience, with a strong preference for healthcare or managed care settings

Minimum 2 years of direct experience working with a Medicare Advantage health plan (required)

Prior experience with ISNP, D-SNP, or dual-eligible populations strongly preferred

Hands-on CMS bid development and HPMS filing experience

Risk adjustment modeling, HCC analysis, and CMS payment reconciliation experience

Part D pricing and/or reconciliation experience a plus

Exposure to RADV audit methodology and encounter data quality a plus

Technical Skills

Advanced proficiency in Excel and actuarial modeling tools

Experience with SAS, R, Python, or SQL for data extraction and analysis

Familiarity with CMS data systems including HPMS, MARx, and RAPS/EDPS

Ability to work with large claims datasets and synthesize findings clearly

Core Competencies

Communication: Translates complex actuarial findings into clear, actionable insights for non-technical audiences including finance, clinical, and executive leadership

Project Management: Manages multiple deliverables across competing deadlines, including bid season, monthly close, and CMS filings

Collaboration: Serves as a trusted cross-functional partner to finance, clinical, compliance, and network teams

Attention to Detail: Maintains strong documentation habits with a CMS audit environment in mind

Adaptability: Comfortable operating in a fast-moving, often ambiguous environment typical of growing health plans