Role Summary

HIGHLIGHTS

Senior health actuarial consulting role focused on Medicaid and state-administered health programs. You will lead actuarial engagements, develop and certify managed care capitation rates, oversee encounter data analytics, and advise on waivers and value-based payment models. Senior, client-facing position reporting to the Principal of the Health Analytics Practice Group; remote or office-based within the US.

JOB DESCRIPTION SUMMARY

Lead actuarial engagements for state Medicaid agencies and public health clients
Develop and certify Medicaid managed care capitation rates and risk adjustment methods
Conduct encounter data analytics and reconcile utilization to financial data
Senior, client-facing consulting role with remote or office work options
Requires ASA or FSA and 15+ years of health actuarial experience

DOMAIN EXPERTISE

Support for state Medicaid agencies
Developing and certifying managed care capitation rates
Designing and applying risk adjustment and risk scoring methodologies
Familiarity with CMS review processes and ASOP compliance
Experience with claims/encounter data, APCDs, and MMIS

KEY REQUIREMENTS

15+ years of health actuarial experience
FSA or ASA with active American Academy of Actuaries membership required
At least 5 years supporting or employed by a state Medicaid agency
Demonstrated ability to lead a team of actuaries
Proven experience developing actuarially sound managed care capitation rates

TECH STACK

Excel
PowerPoint

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Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead actuarial engagements for state Medicaid agencies and public health clients
Develop and certify Medicaid managed care capitation rates and risk adjustment methods
Conduct encounter data analytics and reconcile utilization to financial data
Senior, client-facing consulting role with remote or office work options
Requires ASA or FSA and 15+ years of health actuarial experience

DOMAIN EXPERTISE

Support for state Medicaid agencies
Developing and certifying managed care capitation rates
Designing and applying risk adjustment and risk scoring methodologies
Familiarity with CMS review processes and ASOP compliance
Experience with claims/encounter data, APCDs, and MMIS

KEY REQUIREMENTS

15+ years of health actuarial experience
FSA or ASA with active American Academy of Actuaries membership required
At least 5 years supporting or employed by a state Medicaid agency
Demonstrated ability to lead a team of actuaries
Proven experience developing actuarially sound managed care capitation rates

TECH STACK

Excel
PowerPoint

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead actuarial engagements for state Medicaid agencies and public health clients
Develop and certify Medicaid managed care capitation rates and risk adjustment methods
Conduct encounter data analytics and reconcile utilization to financial data
Senior, client-facing consulting role with remote or office work options
Requires ASA or FSA and 15+ years of health actuarial experience