Assistant Actuary I - (Medicare Part D)
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve.
We are seeking a senior actuary with deep experience in Medicare Part D pricing to join our Government Markets team. This role will have responsibility for the design, development, and ongoing ownership of Part D pricing models, including member-level projections used for forecasting and strategic decision making. Ideal candidates will have hands-on experience with Medicare Part D bid development or prior pharmacy experience.
Key Responsibilities:
- Own end-to-end design, development, and maintenance of Part D pricing models to project member-level drug utilization, cost sharing, plan liability, and CMS payments.
- Translate complex Part D benefit designs, formularies, and CMS rules into robust model logic.
- Lead reconciliation of seriatim model results to aggregate bid components, financial forecasts, and statutory reporting.
- Establish modeling standards, validation frameworks, and documentation practices to ensure accuracy and transparency.
- Provide expert judgment on key pricing assumptions, trends, and emerging risks impacting Part D financial performance.
- Lead scenario analysis and strategic modeling (e.g., benefit redesigns, formulary changes, trend, risk mix, regulatory changes, customer level pricing) using seriatim projections.
- Partner closely with finance, pharmacy, underwriting, product, and strategy teams to inform pricing decisions and corporate forecasts.
- Monitor regulatory developments and CMS guidance, assess financial implications, and recommend pricing or strategy responses.
- Present complex modeling results and recommendations to actuarial leadership and senior management.
- Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.
- 6+ years of actuarial experience, with significant focus on Medicare Part D pricing or pharmacy analytics.
- Associate of the Society of Actuaries (ASA) designation.
- Demonstrated experience building, owning, and validating complex actuarial models
- Strong experience working with detailed healthcare claims data.
- Proficiency in Excel and SQL; experience with R, SAS, or similar tools strongly preferred.
- Strong communication skills, with the ability to translate technical results into clear business insights
Preferred Experience:
- Direct ownership of Part D bid pricing models or major bid components.
- Experience leading or reviewing seriatim or claim-level actuarial models.
- Demonstrated ability to exercise actuarial judgment in ambiguous or evolving regulatory environments.
- Experience influencing pricing or strategy decisions through data-driven analysis.
- Proven ability to manage multiple high-impact priorities in a deadline-driven environment.
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX 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.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
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.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX 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.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.