Actuarial Consultant with Medicaid Experience

About This Role

Provide strategic and technical consulting services to public sector clients with a focus on Medicaid reimbursement and policy. Support business development efforts and contribute to the transformation of the healthcare sector through innovative actuarial solutions.

Responsibilities

• Provide strategic and technical consulting services to public sector clients
• Support engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment
• Support business development efforts for Federal and State governments, employer groups, and other public entities
• Participate in the transformation of the health care sector through innovative actuarial solutions
• Address complex, ill-defined problems with strong technical and innovative approaches
• Apply business-oriented strategies to enhance client outcomes and solutions
• Collaborate with cross-functional teams to deliver comprehensive actuarial services
• Engage in continuous learning and adaptation to emerging health care trends and technologies

Requirements

• 2+ years of health actuary experience and consulting and/or health plan/insurance company experience
• 1+ year(s) of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
• Must be legally authorized to work in the United States without the need for employer sponsorship
• Ability to travel up to 20-50%
• Exam progress towards ASA or FSA
• Bachelor's Degree

Qualifications

• Bachelor's Degree
• 2+ years of health actuary experience and consulting and/or health plan/insurance company experience; 1+ year(s) of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development

Nice to Have

• ASA with progression to FSA, FSA, or career ASA designation
• Experience providing Medicaid consulting services to Government agencies
• Experience with Medicaid waivers (i.e., 1115, 1915 b/c, 1332)
• Experience with risk adjustment mechanisms
• Experience with Provider reimbursement streams (i.e., DSH, UPL, etc.)
• Experience with health care reform and working knowledge of the individual medical and small group markets
• Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various enrollee types
• Experience with reimbursement models - including value based care/ACO modeling
• Knowledge of group insurance products including disability, long term care, etc.

Skills

* Required skills

Certifications