Medicare Part D Actuarial Consultant

Job Summary

A company is looking for a Medicare Part D Actuarial Consultant to support risk adjustment and benefit modeling efforts.

Key Responsibilities

• Review and revise the current Part D actuarial model to enhance robustness and predictive capabilities
• Analyze risk adjustment factors and estimate final risk scores, assessing downstream impacts of changes
• Create documentation and prepare internal staff for operational readiness and knowledge transfer

Required Qualifications

• 10+ years of actuarial experience with Medicare Part D payments and risk adjustment
• Deep knowledge of PDE layouts, DIR reporting, and Part D settlement processes
• Strong coding skills in SQL and SAS
• Experience with risk management and actuarial documentation
• ASA or FSA designation (preferred) or equivalent financial experience in Part D