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Actuary Director - Remote
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- The Actuary Director requires an experienced actuarial viewpoint in a wide variety of actuarial subjects and within the company, industry, and regulatory environment.
- It performs high level actuarial analyses for Medicare Part D business, including, but not limited to: CMS programs, drug expense analyses and projections, financial forecasts, Medicare Part D bid assumption development, actuarial modeling/analysis, pharmacy network management, manufacturer rebate improvement and ad hoc actuarial analyses/advice as needed.
- Utilizes independent judgment and discretion, performs financial projections and actuarial analysis for complex assignments including: Trend Analysis (Internal & Industry comparisons) Network analysis, management, and governance Formulary modeling Impact of Regulatory Changes Bid pricing support
- Assists in the analysis of Part D bid strategy proposals including: Extensive experience and understanding of Part-D bid mechanics and regulations Strategic thought process to optimize Part-D pricing for PDP, MAPD, and DSNP programs Ability to assimilate macro- and micro-trends to develop market competitive products or strategies Cross-functional collaboration on strategy development is critical for the success of the role
- Extensive Medicare knowledge, with specific acumen in Part D, including: Bid preparation and desk review CMS compliance CMS audit requirements
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