Closer to client-facing consulting than a modelling-heavy IC role because the analysis is prepared for proposal evaluation, clarification, negotiation, and government decision-making.
Senior Health actuarial consulting role, 100% remote in the United States, supporting evaluation of major federal managed-care proposals. You will independently assess medical and dental cost projections, assumptions, models, data quality, and rate development, then produce findings for clarifications, negotiations, and source selection. The role suits an experienced actuarial analyst or health actuarial SME with 6+ years of relevant experience.
Requirements
Must have
Must be currently authorized to work in the United States on a full-time basis
Ability to obtain a Public Trust Security Clearance
Strongly preferred
Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Healthcare Analytics, or related field
6+ years of experience performing managed-care actuarial analysis for a Federal healthcare program or major payer
6+ years of experience analyzing healthcare utilization, unit cost, trend, IBNR, risk adjustment, provider reimbursement, and network pricing
6+ years of experience developing written actuarial findings that support proposal clarifications and negotiation positions
ASA, FSA, or equivalent health-actuarial experience
Experience supporting Federal or state healthcare procurements, proposal evaluations, rate reviews, or contract negotiations
Experience with Medicare, Medicaid, TRICARE, VA Community Care, FEHB, commercial managed care, or comparable large-scale healthcare programs
Experience evaluating health-plan, TPA, provider-network, medical, dental, or pharmacy proposals and developing formal actuarial reports
Knowledge of applicable Actuarial Standards of Practice related to data quality, modeling, credibility, healthcare cost estimates, and actuarial communications
Experience using SQL, SAS, R, Python, Power Query, Power BI, or other actuarial and analytical tools
Ability to deliver accurate, defensible actuarial products under compressed source-selection and procurement timelines
Skills & Domain
ToolsPower_BI
DomainFederal healthcare program actuarial analysisHealthcare utilization, cost, and trend analysisIBNR and risk adjustment modelingHealthcare proposal evaluation and rate reviewActuarial findings and negotiation support