Senior Consulting Actuary

BerryDunn

1d•$200,000 - $275,000•Remote

About The Position

BerryDunn is seeking a highly experienced and motivated Senior Consulting Actuary to join our Health Analytics Practice Group. This individual will lead actuarial engagements providing strategic support to state-administered health insurance programs, state insurance regulators, and other state agencies nationwide. Other potential clients include non-profit managed care organizations, accountable care organizations, and large employer groups. This position requires 15+ years of actuarial experience, attainment of Associate or Fellow of the Society of Actuaries, membership in the American Academy of Actuaries, and annual attestation to meeting the US Qualification Standards and Specific Qualification Standards. Five or more years of experience developing and certifying/filing actuarially sound capitation rates with CMS is strongly preferred. This senior role within the actuarial team includes some management responsibilities and offers the potential for growth and advancement. The Senior Consulting Actuary will report to the Principal leading the Health Analytics Practice Group (HAPG), our dedicated health analytics team providing actuarial, health policy analysis, and data management and strategy services. HAPG has helped executives and policymakers in nonprofit health care organizations, government agencies, and purchasers of health insurance pursue their missions by providing clear financial analysis of important decisions that affect health care coverage. We’ve built a reputation for sophisticated, objective, and insightful analysis, and have a team of highly-qualified, outstanding professionals serving our clients. Important and wide-ranging transformation is occurring in the U.S. health system, and we are positioned to help health care organizations with the analytical support they need to navigate change successfully. This position is planned to be either work remotely or sit in one of our nine BerryDunn offices. Travel Expectations: This role requires minimal travel, less than 20% per year.

Requirements

FSA or ASA with active membership in the AAA (required).
15+ years of health actuarial experience, including at least 5 years supporting or employed by a state Medicaid agency.
Demonstrated ability to lead a team of actuaries.
Proven experience developing actuarially sound managed care capitation rates, risk adjustment methodologies, and waiver cost-effectiveness models.
Deep familiarity with CMS review processes, federal regulatory standards, and ASOP compliance.
Expertise with Medicaid and commercial claims/encounter data, including All-Payer Claims Databases (APCDs) and Medicaid Management Information Systems (MMIS).
Excellent communication skills and a strong record of producing defensible actuarial documentation for CMS, state agencies, and legislative oversight entities.
An executive presence and strong client relation skills.
Ability to work in a collaborative environment.
Advanced skills in Microsoft Excel, Word, PowerPoint.

Nice To Haves

Experience providing expert testimony or support in rate hearings and rate negotiations preferred.
A desire to generate new business strongly preferred.

Responsibilities

Lead actuarial engagements for state Medicaid agencies and other public health clients.
Design and oversee encounter data analytics, validating completeness and accuracy, producing utilization trend analyses, and reconciling encounter to financial data for managed care oversight.
Develop and certify Medicaid managed care capitation rates that are actuarially sound, including risk adjustment methodologies.
Develop and apply risk scoring methodologies to support capitation rate rebalancing, including calculation of individual risk scores and risk-adjusted settlements.
Conduct financial analyses and modeling for HCBS, LTSS, and PACE programs.
Provide strategic guidance on program design, waiver development and submission support, and value-based payment models.
Support federal authority activities, including cost-effectiveness and budget-neutrality analyses for 1915(b)/(c) and 1115 waivers, state plan amendments, directed payments, and provider tax programs.
Conduct ad hoc fiscal and policy impact analyses, including rate modifications, hospital rebasing, UPL/GME payments, and pay-for-performance calculations.
Collaborate with multidisciplinary teams including underwriters, policy experts, data analysts, health economists, and clinical consultants.
Present complex actuarial findings to clients, stakeholders, and regulatory bodies in a clear and actionable manner.
Mentor junior actuarial staff and contribute to professional development initiatives.
Stay current with federal and state regulations, CMS guidance, and emerging trends in commercial and public health programs.