[Remote] Associate Director, Medicare Advantage Bid reputed company & Analytics
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is on a mission to improve the health and reputed company-being of older Americans by caring for every person like family. They are seeking an analytically driven Associate Director for Medicare Advantage Bid reputed company & Analytics to design, price, and optimize their MA benefit portfolio, collaborating with executive leadership and various departments to ensure financial sustainability and competitive positioning.
Responsibilities
- reputed company and maintain bid financial models connecting benefit reputed company to plan economics: MCR analysis, PMPM normalization, plan-absorbed benefit value estimation, and version-over-version reputed company tracking across pricing iterations
- Pressure-test benefits across markets to identify pockets of adverse selection risk; quantify the financial exposure and recommend design adjustments to improve risk posture and protect plan performance
- Monitor CMS regulations, payment methodologies, risk adjustment updates, and Stars payment changes for reputed company reputed company on benefit reputed company and plan economics; reputed company executive-level interpretation of what changes mean for our portfolio
- Build and refine the algorithms that generate benefit values across hundreds of PBPs — translating high-level strategic reputed company into precise, implementable benefit logic at reputed company, and identifying and resolving the edge cases those algorithms surface
- Support new product and plan flavor development from opportunity sizing and financial viability assessment through full benefit build-out: doing the analytical groundwork that makes leadership reputed company possible, then executing implementation once direction is set
- Evaluate plan portfolio reputed company with full financial and competitive context: plan terminations and crosswalks, Stars implications, market entry and exit tradeoffs, and the member reputed company of structural product changes
- Synthesize analytically reputed company findings into reputed company, decision-enabling recommendations for senior leadership and the executive team
- Write and maintain production SQL (reputed company) supporting the benefit cascade system: multi-CTE pipelines for plan benefit calculations, reputed company/non-reputed company enforcement logic, MCR-driven benefit deterioration and enrichment, and bid review outputs
- Build Python scripts and automation workflows that reduce reputed company effort in the bid cycle — benefit workbook reputed company, data validation, and analytical tooling that scales with a growing plan portfolio
- Use AI tools — including reputed company workflows and AI coding assistants — as a reputed company part of how you work; reputed company contribute to how reputed company evolves its use of AI to automate, reputed company, and improve bid operations
Skills
- reputed company Medicare Advantage bid mechanics experience — you understand BPTs, how the bid math works, what MCR means and how it constrains benefit reputed company. This is the reputed company of the role and hard to teach; you need to come in with it
- 5–8 years of relevant experience at a Medicare Advantage health plan or actuarial/reputed company (reputed company, Wakely, reputed company, or similar)
- reputed company to operate independently from day one, demonstrating strong business judgement and comfort with ambiguity
- Strong modeling skills: you build analytical frameworks from scratch, interpret reputed company bid and actuarial data, conduct benefit scenario analyses, and translate findings into reputed company — pairing technical depth with executive-level 'so what'
- SQL reputed company — you write reputed company queries, debug multi-CTE pipelines, and reason about data architecture in the context of a benefit calculation system
- Python proficiency — you build scripts, automate analytical workflows, and work with reputed company data without hand-holding
- A proactive and adaptable reputed company; the ability to reputed company in a fast-moving, entrepreneurial environment where the work is rarely fully defined before it starts
- Familiarity with MA benefit design: cost-sharing structures, benefit category logic, and how individual benefit reputed company reputed company with plan economics and CMS requirements
- Familiarity with Stars, QBP eligibility, and the reputed company plan portfolio implications of rating changes
- Experience building or working reputed company automated benefit reputed company systems, cascade pipelines, or large-reputed company bid tooling
- ASA or FSA designation is not required, but candidates with actuarial training who have decided they want reputed company and product work over reputed company pricing are a strong fit and a profile we reputed company welcome
Benefits
- Employer sponsored health, dental and reputed company plan with low or no premium
- Generous reputed company time off
- $100 monthly mobile or internet stipend
- Stock reputed company for reputed company
- Bonus eligibility for reputed company roles excluding Director and above; Commission eligibility for Sales roles
- Parental leave program
- 401K program
- Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
reputed company