Senior Consulting Actuary
About The Position
BerryDunn is seeking a highly experienced and motivated Senior Consulting Actuary to join their 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. Potential clients also include non-profit managed care organizations, accountable care organizations, and large employer groups. The role 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. This senior role includes management responsibilities and offers potential for growth and advancement, reporting to the Principal leading the Health Analytics Practice Group (HAPG). HAPG is a dedicated health analytics team providing actuarial, health policy analysis, and data management and strategy services, known for sophisticated, objective, and insightful analysis. The position can be remote or based in one of BerryDunn's nine offices, with minimal travel (less than 20% per year). BerryDunn, founded in 1974, is a client-centered, people-first professional services firm that helps businesses, nonprofits, and government agencies solve challenges, recognized for its diverse and inclusive workplace culture, and focus on learning, development, and well-being.
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.
- Advanced skills in Microsoft Excel, Word, PowerPoint.
Nice To Haves
- Five or more years of experience developing and certifying/filing actuarially sound capitation rates with CMS is strongly preferred.
- 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.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
