Senior Manager, Medicare Advantage Portfolio Strategy, Analytics

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of strategic analysis related to decisions in the Medicare Advantage portfolio, encompassing product and service-area mix.

• Identify key strategic questions that influence growth and margin decisions, driving comprehensive analysis.

• Break down PMPM trends into utilization and unit cost components.

• Create robust comparison groups and estimate the impact of benefit or network modifications on claims.

• Evaluate the effects of benefit design on revenue and costs independently, while acknowledging the limitations of these estimates.

• Present and advocate for data-driven recommendations to senior leadership, including the CEO.

• Develop agentic workflows, AI-assisted coding processes, and automated pipelines for portfolio and bid-cycle tasks.

• Provide analytical support to go-to-market teams for marketing, sales, and broker initiatives.

• Track AEP enrollment against bid assumptions based on plan, county, product mix, and member demographics.

• Act as the internal expert for metric definitions and data interpretation.

⛳️ Requirements

• Minimum of six years of experience in Medicare Advantage with hands-on data analysis expertise.

• Familiarity with claims structure, place-of-service and revenue codes, as well as the differences between allowed and paid amounts, completion factors, and risk adjustment.

• Proficient in cost and utilization analytics, including PMPM trend decomposition, comparison groups, and impact assessment.

• Strong SQL skills and comfort working with large claims data warehouses like Snowflake, Databricks, or similar platforms.

• Proven track record of translating claims analysis into strategic recommendations and defending these to senior leadership.

• Capacity to work independently throughout the entire process: sourcing data, validating it, modeling, and presenting findings.

• Ability to convey complex results in a clear and concise manner, whether in a single slide or a Slack message.

• Collaborative approach with a willingness to communicate consistently in a remote setting.

• Proficient and practical use of AI tools in analytical tasks.

• Experience in bid mathematics, including benchmarks, rebates, benefit valuation, and CMS bid-cycle assumptions (preferred).

• Background in optimization, Python, or actuarial training applied to strategy (preferred).

• Skills in Python analysis and modeling, utilizing libraries such as pandas, statsmodels, scikit-learn, clustering, regression, PCA, and decision trees (preferred).

• ASA or FSA actuarial credentials are not mandatory.

🏝️ Benefits

• Employer-sponsored health, dental, and vision insurance plans with low or no premiums.

• Generous paid time off policy.

• Monthly stipend of $100 for mobile or internet services.

• Stock options available to all employees.

• Bonus eligibility for all positions, excluding Director-level and above.

• Commission eligibility for sales positions.

• Comprehensive parental leave program.

• 401K retirement plan.