Closer to consulting than a pricing-underwriting partner role because the work evaluates external proposals and supports acquisition negotiations rather than live insurance portfolio decisions.
Senior Health actuarial consulting role supporting evaluation of complex managed-care medical and dental proposals in the United States. You will validate pricing models, healthcare cost and utilization assumptions, data, and risk adjustments; prepare Price Analysis Report findings; and support negotiations with acquisition personnel and senior Government decision-makers. The role is 100% remote and offers $130,000-$180,000 annually.
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 Finance, Economics, Mathematics, Actuarial Science, Statistics, Healthcare Administration, or a related field
8+ years of experience in healthcare actuarial analysis, managed-care analytics, healthcare economics, rate development, or related work
6+ years of experience developing, reviewing, or validating managed healthcare cost and utilization projections, including experience with utilization forecasting, medical trend, unit cost, provider reimbursement, risk adjustment, rate development, claims completion/IBNR, or experience studies
6+ years of experience independently evaluating actuarial assumptions and complex models, with advanced Excel, strong technical-writing skills, and ability to communicate actuarial findings to non-actuarial stakeholders under compressed deadlines
Nice to have
Experience supporting federal or state healthcare procurements, proposal evaluations, rate reviews, or contract negotiations
Experience with Medicare, Medicaid, TRICARE, VA Community Care, Federal Employees Health Benefits, commercial managed care, or comparable large healthcare programs
Knowledge of applicable Actuarial Standards of Practice, particularly those addressing data quality, modeling, credibility, healthcare cost estimates, and communications
Experience using SQL, SAS, R, Python, Power Query, Power BI, or other actuarial and analytical tools
DomainHealthcare actuarial analysis and managed-care analyticsDeveloping or validating managed healthcare cost and utilization projectionsExperience with Medicare, Medicaid, TRICARE, or similar programs
Subject Matter Expert - Senior Healthcare Actuarial SME