Job Description
📋 Description Lead complex healthcare actuarial projects and provide strategic client guidance. Develop and certify Medicaid managed care capitation rates, risk adjustment methods, and supporting Design/oversee encounter data analysis, validation, utilization trends, and reconciling data with Conduct financial modeling for HC programs (HCBS, LTSS, PACE, waivers, value-based payments). Support regulatory activities via cost-effectiveness analyses, budget neutrality, and waivers. Present findings to clients, stakeholders, and regulatory bodies clearly and actionabley. 🎯 Requirements ASA or Fellow of the Society of Actuaries with AAA active membership. Minimum 15 years healthcare actuarial experience, including Medicaid. At least 5 years in certifying Medicaid capitation rates. Proven leadership of actuarial teams and complex client engagements. Strong expertise in Medicaid/commercial data: claims, encounter data, APCDs, MMIS. CMS review processes, healthcare regulations, and ASOP compliance. 🎁 Benefits Competitive base salary: $200,000 - $275,000 (USD). Flexible work options, including remote or office-based opportunities. Comprehensive benefits to support well-being and professional growth. Career growth, leadership development, and mentorship. Collaborative environment with healthcare, actuarial, analytics, and consulting experts. Professional development and meaningful work supporting healthcare programs.
