Senior Consulting Actuary - ACA Pricing

Wakely Consulting Group•,

About The Position

Wakely, an HMA company, is seeking a Senior Consulting Actuary with deep expertise in ACA pricing, strategy, and market dynamics. This individual will play a key role in leading client engagements, shaping innovative solutions, and mentoring the next generation of consultants. The Senior Consulting Actuary I is responsible for managing Wakely’s client relationships by designing and monitoring plans to achieve strategic goals. In addition, the position will manage actuarial project teams to ensure quality and timely deliverables. This role has supervisory responsibilities.

Requirements

Demonstrated experience with ACA rating rules and premium rate certification.
Strong technical expertise in claims analysis, risk adjustment, and market modeling.
Proven ability to build trust with clients and influence decision-making at the leadership level.
Excellent communication skills and ability to work effectively across cross-functional teams.
Minimum of a bachelor’s degree in actuarial science, mathematics, economics, or statistics required.
FSA designation or ASA designation with additional experience also required.
Minimum of 8 years of healthcare actuarial experience in one of more of Wakely’s core areas (Medicaid, healthcare reform, ACA, Provider Sponsored Organizations and Medicare Advantage), with at least 2 years of project management or client management experience required.
Initiative - Ability to decide in an independent way what actions should be taken
Effective Communication - Demonstrates the ability to convey thoughts and express ideas effectively, both verbally and written
Team Player - Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect
Time Management - Makes reasonable estimates of resources needed to achieve goals or complete projects. Uses methods to plan and track work and commitments
Continuous Learning - Displays an ongoing commitment to increasing skills
Leadership - Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and opportunities to learn through formal and informal methods
Emotional Intelligence - Consistently exercises sound judgment
Strategic Thinking - Formulates objectives and priorities, and implements plans consistent with the long-term interest of the organization and employees

Nice To Haves

Strategic thinker who anticipates market and regulatory changes and translates them into actionable client strategies.
Passion for mentoring and developing actuarial talent.

Responsibilities

Lead and certify ACA premium rate filings for individual and small group markets, ensuring compliance with rating rules and regulatory requirements.
Analyze detailed claim and enrollment data to inform pricing, forecasting, and strategic decision-making.
Partner with clients to develop and implement product, pricing, and market strategies that respond to regulatory and competitive changes.
Conceptualize and model the impact of policy shifts and competitor actions on client portfolios.
Advise on plan design and product development, aligning actuarial insights with client goals.
Communicate complex findings and recommendations to client executives and stakeholders in a clear, compelling manner.
Foster strong client relationships while also coaching and developing junior team members.
Collaborate across teams to deliver integrated, forward-thinking solutions.
Develop and Maintain Client Relationships
Implement initiatives for Wakely products, tools and services through training and regular meetings
Manage and understand individual client needs and develops a strategic plan to meet those needs
Manage client relationships to include client visits, ongoing correspondence and feedback
Mitigate risk by ensuring client contracts, documentation and processes are followed
Supervise and Account for the Execution of Project Plan
Conduct periodic reviews of project plans, final deliverables and post project results
Oversee project communication and provide venues for constructive feedback
Ensure project team is providing quality deliverables, updates and billing clients within timelines
Appropriate delegation of work
Gain and Sustain Professional/Industry Knowledge
Maintain credentials, signing authority and health care knowledge through continuing education
Implement industry training for internal/external initiatives
Identify needs and align employee career path plan
Manage the creation of additional resources and reference materials
Seek Opportunities for the Organization's Growth
Implement brand recognition through participating in seminars/events and research papers, etc.
Generate new business and/or product lines by executing on established action plans
Manage new marketing initiatives to generate sales leads
Introduce new value add services to current clients
Manage Best Business Practice
Prioritize and manage operational efficiency initiatives
Administer compliance of policies and procedures to ensure cross office collaboration
Recruit top talent and participate in the selection and orientation process
Oversee and participate in community and professional volunteer activities/opportunities
All other duties as assigned.