Subject Matter Expert - Senior Healthcare Actuarial SME
Blake Willson Group
Subject Matter Expert - Senior Healthcare Actuarial SME
United States · Remote · 1mo ago
Medicare AdvantageMedicaidHealth Other
Closed
- Salary
- $130k - $180k
- Experience
- 6+ Years
Role Summary
Role type
Federal healthcare procurement consultant
Closer to client-facing consulting than a modelling-heavy IC role because the analysis directly informs government clarifications, negotiations, and source selection.
Senior Health actuarial consulting role, fully remote in the United States, supporting evaluation of a major federal managed-care procurement. You will assess medical and dental cost projections, models, assumptions, data quality, and rate development, then prepare findings for clarifications, negotiations, and source selection.
Requirements
Must have
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Healthcare Analytics or related field
- 6+ years performing managed-care actuarial analysis for a Federal healthcare program or major payer, including proposal, bid, or rate-submission evaluation
- 6+ years analyzing healthcare utilization, unit cost, trend, IBNR, risk adjustment, provider reimbursement, and network pricing, with demonstrated experience developing, reviewing or validating complex healthcare cost projections
- 6+ years developing written actuarial findings supporting proposal clarifications and negotiation positions, preferably with ASA/FSA or equivalent health-actuarial experience and Federal acquisition experience
- Must be authorized to work in the United States on a full-time basis
- Ability to obtain a Public Trust Security Clearance
Strongly preferred
- ASA, FSA, or extensive equivalent health-actuarial experience
- Experience supporting Federal or state healthcare procurements, proposal evaluations, rate reviews, or contract negotiations
- Experience with Medicare, Medicaid, TRICARE, VA Community Care, FEHB, commercial managed care or comparable large-scale healthcare programs
- Experience evaluating health-plan, TPA, provider-network, medical, dental, or pharmacy proposals and developing formal actuarial reports, proposal findings, rate certifications, or negotiation-support analyses
- Experience using SQL, SAS, R, Python, Power Query, Power BI, or other actuarial and analytical tools
- Demonstrated ability to deliver accurate, defensible actuarial products under compressed source-selection and procurement timelines
Skills & Domain
ToolsExcelPower_BIPowerPointJupyter_Notebook
DomainFederal healthcare program actuarial analysisManaged-care proposal or rate evaluationHealthcare utilization and cost projectionExperience with Medicare, Medicaid, TRICARE, FEHB or comparable
