Actuarial Senior Consultant with Medicaid Experience
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Upload Your ResumeAbout This Role
This role involves providing strategic and technical consulting services to public sector clients, specifically focusing on Medicaid reimbursement and policy. The consultant will transform the healthcare sector through innovative actuarial solutions and collaborate with cross-functional teams.
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, such as AI-driven solutions, development of frameworks inclusive of social drivers of health, and transition of payment models to value-based payment frameworks
- 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
- 5+ years of health actuary experience
- Consulting and/or health plan/insurance company experience
- 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
- Exam progress towards ASA or FSA
- Bachelor's Degree
- Legally authorized to work in the United States without employer sponsorship
Qualifications
- Bachelor's Degree
- 5+ years of health actuary experience and consulting and/or health plan/insurance company experience; 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
Nice to Have
- 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 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
About Deloitte
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