Staff Actuary - Medicare & Government Programs (Remote) 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.