Senior Consulting Actuary
FlexibleMedicaidCommercial Employer HealthPricing & RatingExperience StudiesPredictive Modelling & ML
Role Summary
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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
