Actuarial Analyst II (Medicare Part D)

Key Responsibilities

• Design, build, and maintain Part D pricing models to project member-level drug utilization, cost sharing, plan liability, and CMS payments.
• Translate Part D benefit designs, formularies, and CMS rules into detailed model logic.
• Perform reconciliation of model results to aggregate bid components and financial reporting.
• Work directly with raw claims and enrollment data to support model inputs, assumptions, and calibration.
• Support scenario testing (e.g. benefit changes, trend, risk mix) and customer level pricing using seriatim projections.
• Collaborate with cross-functional teams, including finance, underwriting, and product development, in support of pricing analyses and corporate strategy and forecasts.
• Monitor regulatory changes and assess their impact on pricing and profitability.
• Present findings and recommendations to the Actuarial Manager.
• Document model logic, assumptions, and validation results.

Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.
• 2+ years of actuarial experience, with a focus on Medicare Part D pricing or pharmacy.
• Completion of 4+ actuarial exams.
• Experience working with detailed healthcare claims data.
• Proficiency in Excel and SQL. R/SAS experience preferred.
• Excellent communication and collaboration skills.

Preferred Experience

• Prior experience with Part D pricing models, claim-level analytics, or seriatim forecasting.
• Demonstrated ability to work independently and drive projects forward with minimal oversight.
• Proven track record of taking initiative, managing competing priorities, and delivering high-quality work in a deadline-driven environment.

About the Role

We are seeking an actuarial professional with a background in Medicare Part D pricing to join our Government Markets team. This role will have meaningful responsibility for the development and ongoing enhancement of Part D pricing models, with increasing ownership over time. Ideal candidates will have hands-on experience with Medicare Part D bid development or prior pharmacy experience.

Benefits

This role is designated as a role that fits into the “Hybrid” model. Associates will work in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday).

Pay

The salary range for this role is $70,000 - $100,000 annually, commensurate with experience.

Schedule

The role is designated as a role that fits into the “Hybrid” model. Associates will work in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday).

Skills

Skills required for this role include proficiency in Excel and SQL. R/SAS experience is preferred.

Benefits

Independence offers a comprehensive benefits package including medical, dental, vision, life insurance, disability, and 401(k) retirement savings plan. Additionally, employees may participate in the company's wellness program and have access to a variety of resources to support their overall well-being.

Company Information

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

Equal Employment Opportunity

Independence Blue Cross is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.