Senior Consulting Actuary
FlexibleMedicaidCommercial Employer HealthPricing & RatingProduct Development & Plan DesignPredictive Modelling & ML
Role Summary
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Senior health consulting actuary role supporting state Medicaid programs and other public health clients. You will lead engagement teams to develop and certify Medicaid managed care capitation rates, perform encounter data analytics, risk adjustment, waiver cost-effectiveness analyses, and present findings to regulators. Remote or office-based in one of BerryDunn’s US offices with minimal travel.
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
- Perform encounter data analytics and reconcile claims to financials
- Client-facing senior role with mentoring and some management responsibilities
- Flexible work arrangement: remote or in-office at one of nine US offices
DOMAIN EXPERTISE
- Support for state Medicaid agencies
- Developing and certifying Medicaid managed care capitation rates with CMS
- Designing and applying risk adjustment methodologies
- Experience with Medicaid and commercial claims/encounter data (APCDs, MMIS)
- Waiver cost-effectiveness and 1915/1115 waiver analyses
KEY REQUIREMENTS
- 15+ years of health actuarial experience
- FSA or ASA with active AAA membership (required)
- 5+ years supporting or employed by a state Medicaid agency
- Proven experience certifying capitation rates with CMS
- Ability to lead a team of actuaries and present to regulators
TECH STACK
- Excel
- PowerPoint
- Word
