VP, Medicare Advantage Chief Actuary (Medicare Advantage)

Location: Virtual – Microsoft Teams; candidates must be authorized to work in the United States

Salary: $175,300–$249,100 annually, with possible performance-based incentive and/or equity.

Company

hirify.global develops healthcare solutions focused on improving care delivery and healthcare outcomes.

What you will do

• Lead the Medicare Advantage actuarial function, including strategy, staffing, coaching, resource allocation, budgeting, succession planning, and credentialing support.
• Direct Medicare Advantage product design, pricing architecture, Part C and Part D bid development, actuarial modeling, certification, documentation, and HPMS submission.
• Oversee valuation, IBNR and premium deficiency reserves, risk-sharing settlements, financial reporting, internal controls, and statutory compliance.
• Model CMS Advance Notices, Final Rate Announcements, benchmark changes, CMS-HCC V24-to-V28 transition impacts, Star Ratings economics, and risk adjustment trends.
• Provide executive leadership and Board reporting on MLR, claims trends, membership, revenue, profitability, risk scores, and bid-to-actual performance.
• Partner with Risk Adjustment, Pharmacy, Product, Finance, Clinical, Network, Market Growth, Quality, and Stars Strategy leaders.

Requirements

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or a related quantitative field.
• FSA and MAAA in good standing, meeting qualification standards to issue Statements of Actuarial Opinion and CMS Medicare Advantage Part C and Part D Actuarial Certifications.
• 15+ years of health actuarial experience, including 7–10 years of direct senior leadership experience in Medicare Advantage bid preparation, Part C/Part D pricing, reserving, risk adjustment, and CMS health plan financial management.
• Significant executive leadership experience within a Medicare Advantage organization, HMO, or national managed care carrier, with exposure to executive leadership and governing boards.
• Expert knowledge of CMS bid mechanics, HPMS filings, CMS-HCC and RxHCC risk adjustment models, Part D subsidy and formulary economics, Star Ratings financial mechanics, and statutory IBNR reserving.
• Deep understanding of healthcare economics, actuarial and accounting practices, value-based care, capitation, two-sided risk sharing, and Medicare Advantage statutory balance sheet management.
• Experience developing and empowering cross-functional teams of credentialed actuaries, actuarial students, and healthcare economics data analysts.
• Experience developing pricing strategies for new products, innovative services, specialized MA plans such as Chronic or Dual-Eligible SNPs, and supplemental benefit packages.
• Ability to deliver results under statutory timelines, evaluate AEP targets and service-area expansion, present complex models and financial trade-offs to executives and Board committees, and prioritize work during bid and regulatory filing cycles.
• Strong written, verbal, communication, negotiation, collaboration, integrity, and ethical decision-making skills.

Culture & Benefits

• Full-time employment in normal office working conditions while working virtually through Microsoft Teams.
• Medical, vision, dental, life, disability, FSA, and HSA benefits.
• Paid time off, sick time, paid leave, volunteer and wellness days, and an employee assistance program.
• 401(k) with company match, employee resource groups, employee discounts, and learning and development opportunities.
• No member-facing duties, drug screen, MVR, or credit check are required.
• Visa sponsorship is not available; candidates must already be authorized to work in the United States.