Senior Consulting Actuary - Risk Adjustment

Wakely Consulting Group•,

About The Position

Wakely, an HMA company, is seeking a Senior Consulting Actuary with specialized experience in Affordable Care Act (ACA) risk adjustment analytics. The role leads client engagements, coordinates multidisciplinary teams, develops actionable recommendations, and supports the growth of Wakely’s risk adjustment offerings. It includes managing client relationships and actuarial project teams, with supervisory responsibilities. The position leads ACA risk adjustment analyses, including risk accrual development and EDGE data evaluation, and provides strategic support to health plan executives on financial and operational impacts. The Senior Consulting Actuary manages project plans, workflows, timelines, and deliverables across multiple engagements; ensures quality and timely work; mentors staff; and communicates findings and recommendations to client leadership. The role also applies Wakely tools, products, and methodologies; supports proposals, strategic scoping, service innovation, and business development; monitors market and regulatory developments; and translates changes into practical client strategies. Broader responsibilities include maintaining professional credentials and industry knowledge, developing resources and training, improving internal operations, supporting recruitment, and participating in professional and community activities.

Requirements

Bachelor’s degree in actuarial science, mathematics, economics, or statistics.
FSA designation, or ASA designation with additional experience.
At least 8 years of healthcare actuarial experience in one or more of Wakely’s core areas: Medicaid, healthcare reform, ACA, Provider Sponsored Organizations, or Medicare Advantage.
At least 2 years of project management or client management experience.
Demonstrated experience leading ACA risk adjustment analytics within a health plan or leading strategic risk adjustment consulting engagements.
Deep understanding of the ACA risk adjustment program and its effects on health plan rate filings and financial performance.
Strong knowledge of the full risk adjustment lifecycle, including coding, submissions, analytics, provider engagement, and regulatory requirements.
Ability to manage projects, workflows, timelines, and deliverables across multiple engagements.
Ability to anticipate market or regulatory changes and turn them into actionable client recommendations.
Ability to build trusted client relationships and communicate complex technical, analytical, and operational concepts clearly to senior leaders.
Leadership, initiative, accountability, sound judgment, and commitment to mentoring team members.
Excellent written and verbal communication skills and ability to work across cross-functional, multidisciplinary teams.
Ability to make independent decisions, manage time and resources, continue learning, collaborate respectfully, and think strategically.

Responsibilities

Serve as a primary client contact and build and maintain client relationships through meetings, visits, correspondence, and feedback.
Understand client needs and develop strategic plans to meet them; implement Wakely products, tools, and services through training and regular meetings.
Lead ACA risk adjustment analyses, including accrual development and EDGE data evaluation, and assess financial and operational impacts.
Manage project plans, timelines, workflows, communications, and deliverables across multiple engagements.
Supervise project teams, delegate work appropriately, review plans and deliverables, and ensure high-quality, timely work and client billing.
Present findings, recommendations, and risk adjustment concepts clearly to client leadership.
Mentor team members, provide feedback, support employee development, and contribute to a collaborative learning environment.
Apply Wakely tools, products, methodologies, and risk adjustment expertise to client needs and internal initiatives.
Contribute to requests for proposals, proposal development, strategic scoping, service innovation, and growth of risk adjustment offerings.
Monitor ACA risk adjustment market and regulatory developments and translate changes into practical client strategies.
Maintain professional credentials, signing authority, and healthcare knowledge through continuing education; implement industry training and develop resources and reference materials.
Mitigate risk by ensuring client contracts, documentation, and processes are followed.
Support business development through seminars, events, research papers, marketing initiatives, new business or product lines, and value-added services for existing clients.
Prioritize operational efficiency initiatives and ensure compliance with policies and procedures that support cross-office collaboration.
Recruit talent and participate in selection and orientation; oversee or participate in community and professional volunteer opportunities.
Perform other duties as assigned.