Staff Actuary (Medicare)

A leading, well-established health plan is seeking a Staff Actuary to join its growing actuarial team. This organization serves millions of members across a major U.S. regional market and has built a strong reputation over several decades for stability, innovation, and community impact. This is a high-impact, high-visibility role focused on pricing strategy and rate development across Medicare Advantage and State-Sponsored programs (Medicaid) . Key Responsibilities Lead pricing strategy and rate development for Medicare and government-sponsored lines of business Partner cross-functionally with Finance, Product, and Risk Adjustment teams to drive key business decisions Support CMS and state regulatory filings , ensuring compliance and accuracy Analyze and optimize risk adjustment performance and premium adequacy Contribute to enterprise-level financial strategy and performance evaluation Collaborate with leadership on long-term pricing and growth initiatives Why This Role Stands Out Fully remote with flexibility, without sacrificing scope or visibility Highly strategic position influencing multimillion-dollar premium decisions Opportunity to step into a leadership track , with the ability to mentor and manage junior actuaries over time Broad exposure to Medicare Advantage, Medicaid, risk adjustment, and regulatory frameworks Join a mission-driven, financially stable organization with a strong market presence Qualifications ASA designation required 5-8+ years of actuarial experience within managed care Direct Medicare Advantage experience required (Medicaid exposure is a plus) Strong background in pricing, rate filing, and regulatory submissions Experience collaborating with cross-functional stakeholders Prior experience mentoring or overseeing junior staff is highly preferred Familiarity with CMS regulations and risk adjustment methodologies is a strong advantage If you're looking for a strategic actuarial role with clear visibility, leadership upside, and flexibility , this is an excellent opportunity to make a meaningful impact within a respected health plan.