Consulting Actuary II - ACA Risk Adjustment
ACA ExchangeMedicare AdvantageMedicaidCommercial Employer HealthPredictive Modelling & MLBusiness Intelligence & ReportingReserving & Valuation
Role Summary
Loading...HIGHLIGHTS
Mid-level Health consulting actuary focused on ACA risk adjustment operations and analytics across Medicare, Medicaid, and ACA. You will lead client engagements, manage project timelines, mentor junior analysts, and perform risk-adjustment modeling and accrual setting for US clients. Role is client-facing and involves business development and cross-functional collaboration.
JOB DESCRIPTION SUMMARY
- Lead client engagements on ACA risk adjustment operations and accruals
- Perform risk-adjustment modeling and transfer calculations
- Manage projects, timelines, and delegate/train junior analysts
- Client-facing role with business development and RFP support
- ASA required; experience with SQL/SAS, Excel, and Access
DOMAIN EXPERTISE
- ACA risk adjustment operations and accrual setting
- Risk adjustment transfer calculations and modeling
- Claims analysis for health risk adjustment
- Experience with Medicare, commercial ACA, or Medicaid
KEY REQUIREMENTS
- ASA certification and bachelor's degree required
- Minimum 4 years healthcare actuarial experience (Medicare/ACA/Medicaid)
- Demonstrated ACA risk adjustment operations and accrual setting experience
- Technical experience in claims analysis and risk-adjustment modeling
- Proficiency with SQL or SAS and Excel/Access
TECH STACK
- Excel
- Access
