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
Subject Matter Expert - Senior Healthcare Actuarial SME