Senior Actuarial Consultant
Blake Willson Group
- Salary
- $167k - $201kest.
- Experience
- 7+ Years
Role Summary
Role type
Healthcare procurement consultant
Closer to a client-facing consulting role than a modelling-heavy IC one because recommendations support negotiations and Government source selection.
Senior Health actuarial consulting role supporting a major federal healthcare procurement in the United States. Working remotely, you will evaluate proposal pricing, healthcare cost and utilization models, reimbursement, risk adjustment, rate development, and underlying data, then provide findings for negotiations and source selection.
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 a related field
- 7+ years of experience in healthcare actuarial analysis, managed-care analytics, healthcare economics, reimbursement, claims analytics, healthcare pricing, data analytics, or a related field
- 3+ years of recent hands-on experience developing, maintaining, materially modifying, testing, or independently validating healthcare cost, utilization, reimbursement, pricing, or rate-development models, including direct analysis of underlying healthcare data and assumptions
Nice to have
- Experience evaluating another organization's healthcare pricing, rates, actuarial submissions, reimbursement proposals, analytical models, or underlying assumptions for a purchaser, regulator, health plan, Government agency, or advisory client
- Experience supporting federal or state healthcare procurements, proposal evaluations, price analysis, clarification development, negotiation support, source selection, or related acquisition activities
- Experience with Medicare, Medicaid, TRICARE, VA Community Care, FEHB, commercial managed care, or other large-scale healthcare programs, including medical, dental, pharmacy, health-plan, TPA, or provider-network environments
- Experience analyzing healthcare data, including claims, encounter, eligibility, membership, provider, reimbursement, and utilization data, and performing data validation, reconciliation, trend analysis, benchmarking, sensitivity analysis, or scenario modeling
- Experience using SQL, SAS, R, Python, Power BI, Power Query, Excel, or other analytical, actuarial, modeling, or business intelligence tools, with the ability to develop clear analytical reports, proposal findings, price analyses, or negotiation-support materials
- ASA or FSA designation, membership in the American Academy of Actuaries, active progress toward an actuarial credential, or substantial equivalent healthcare actuarial experience, with demonstrated ability to communicate complex analytical findings and deliver accurate, traceable products under compressed procurement timelines
Skills & Domain
ToolsExcelPower_BI
DomainHealthcare actuarial analysisManaged-care analyticsHealthcare pricing and rate developmentClaims and encounter data analysisHealthcare cost/utilization modeling
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