Healthcare Consulting Actuary – Provider & Value-Based Care (FSA)

Milliman•Denver, CO

5d•Remote

About The Position

Milliman's Mountain Gulf Health Practice is seeking a Healthcare Actuary to work full-time with provider clients. You'd be supporting health systems, physician groups, and ACO enablers who are taking on risk under various value-based payment models. You need to be technically strong and have sound judgment about which analysis answers the question client leadership is asking, then explain it in a way that is clear and supports decision making. You will also need to be self-directed. We provide extensive on-the-job training in consulting skills and advanced actuarial techniques. Independent for over 75 years, Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation. Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERGs) are employee-led communities that influence policy decisions, develop future leaders, and amplify the voices of their constituents. We encourage our employees to give back to their varied professions, including leadership in professional organizations. Please visit our web site (https://www.milliman.com/en/social-impact) to learn more about Milliman's commitments to our people, inclusion, and sustainability. Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

Requirements

Bachelor's degree in actuarial science, math, statistics, economics, or something similarly quantitative
FSA designation
Five to eight years in healthcare actuarial work, with a solid understanding of provider perspectives
Hands-on knowledge of at least one CMS or CMMI total cost of care program (MSSP, ACO REACH, Primary Care First, a bundled payment model).
Experience building benchmarks for CMS/CMMI programs and/or other risk-based arrangements
Experience with attribution methodologies
Familiarity with provider reimbursement: fee schedules, capitation, case rates, episode payments
Excel expertise
Experience managing projects: scoping, budget, delegation, timelines, client contact
Ability to explain technical work to people who are not technical
Solid understanding of the US healthcare system
Experience working with detailed healthcare claims data
SQL, Python, R, or SAS

Nice To Haves

Experience with CMS claim and claim line feed (CCLF) data
Experience modeling participation decisions across CMS and CMMI programs
Experience supporting payer contract negotiations
Experience drafting proposals or client reports

Responsibilities

Model provider performance under MSSP, ACO REACH, and LEAD. That means benchmark projection, attribution, risk score dynamics, savings and loss estimation, and scenario testing across risk tracks.
Evaluate value-based contracts from the provider side: shared savings and downside risk, global and primary care capitation, episode and bundled payments, and how risk and reward get distributed downstream.
Model reimbursement and support rate negotiations with payers.
Dig into claims, enrollment, and CMS data to answer questions about utilization, cost drivers, risk adjustment, and network performance.
Run projects. Scoping, budgets, delegating technical work to analysts and students, holding timelines, talking to clients directly.
Draft the client-facing material: emails, memos, decks, and reports written for CFOs and medical group leadership.
Help write proposals alongside a senior consultant.
Support other types of clients and projects in the practice, as needed.
As careers grow at Milliman, consultants take on their own client relationships and lead business development. That is not the initial focus of this role, but it is a natural next step and we will support you toward it.

Benefits

Medical, Dental and Vision — Coverage for employees, dependents, and domestic partners.
Employee Assistance Program (EAP) — Confidential support for personal and work-related challenges.
401(k) Plan — Includes a company matching program and profit-sharing contributions.
Discretionary Bonus Program — Recognizing employee contributions.
Flexible Spending Accounts (FSA) — Pre-tax savings for dependent care, transportation, and eligible medical expenses.
Paid Time Off (PTO) — Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.
Holidays — A minimum of 10 paid holidays per year.
Family Building Benefits — Includes adoption and fertility assistance.
Paid Parental Leave — Up to 11 weeks of paid leave for employees who meet eligibility criteria.
Life Insurance & AD&D — 100% of premiums covered by Milliman.
Short-Term and Long-Term Disability — Fully paid by Milliman.