Healthcare Associate Actuary – Provider & Value-Based Care

This is a fully remote position, open to applicants in United States.

📋 Description

• Model provider performance under MSSP, ACO REACH, and LEAD, which includes benchmark projections, attribution, risk score dynamics, savings and loss estimation, and scenario testing.

• Evaluate provider-centric value-based contracts, encompassing shared savings and downside risk, global and primary care capitation, episode and bundled payments, as well as downstream risk/reward distribution.

• Construct reimbursement models and assist in rate negotiations with payers.

• Analyze claims, enrollment, and CMS data to address inquiries regarding utilization, cost drivers, risk adjustment, and network performance.

• Manage projects by defining work scopes, overseeing budgets, delegating technical tasks, adhering to timelines, and maintaining direct communication with clients.

• Compose client-facing emails, memos, presentations, and reports for CFOs and medical group leadership.

• Collaborate with a senior consultant to assist in writing proposals.

• Provide support for other clients and projects within the practice as necessary.

• Advance toward owning client relationships and leading business development as your career progresses.

⛳️ Requirements

• Bachelor’s degree in actuarial science, mathematics, statistics, economics, or a closely related quantitative field.

• ASA designation with ongoing progress towards FSA.

• Five to eight years of experience in healthcare actuarial work.

• Strong understanding of provider perspectives.

• Practical knowledge of at least one CMS or CMMI total cost of care program, including MSSP, ACO REACH, Primary Care First, or a bundled payment model.

• Experience in developing benchmarks for CMS/CMMI programs and/or other risk-based arrangements.

• Familiarity with attribution methodologies.

• Knowledge of provider reimbursement structures, including fee schedules, capitation, case rates, and episode payments.

• Expertise in Excel.

• Experience in project management, covering scoping, budgets, delegation, timelines, and client interaction.

• Capability to translate technical work for non-technical audiences.

• Comprehensive understanding of the US healthcare system.

• Experience handling detailed healthcare claims data.

• Proficiency in SQL, Python, R, or SAS.

• Proactive approach to decision-making with the ability to anticipate analytical and client needs.

• Strong writing and communication skills.

• Ability to work independently as well as part of a team.

• Capacity to maintain steady performance in a fast-paced, client-oriented environment.

• Entrepreneurial mindset.

• Preferred experience with CMS claim and claim line feed (CCLF) data.

• Preferred experience modeling participation decisions across CMS and CMMI programs.

• Preferred experience supporting payer contract negotiations.

• Preferred experience in drafting proposals or client reports.

• Must be legally authorized to work in the United States without immigration support or sponsorship from Milliman, now or in the future.

🏝️ Benefits

• Medical, Dental, and Vision coverage for employees, dependents, and domestic partners.

• Employee Assistance Program (EAP).

• 401(k) plan featuring company matching and profit-sharing contributions.

• Discretionary Bonus Program.

• Flexible Spending Accounts (FSA).

• Paid Time Off (15 days annually for full-time employees; prorated for part-time employees).

• A minimum of 10 paid holidays each year.

• Family Building Benefits, which include adoption and fertility assistance.

• Up to 11 weeks of paid parental leave for eligible employees.

• Life Insurance & AD&D with Milliman covering 100% of premiums.

• Short-Term and Long-Term Disability fully funded by Milliman.

• Remote work opportunity, with the option to work onsite at select Milliman offices.

• On-the-job training in consulting skills and advanced actuarial techniques.

• Opportunities for skills training, career development, learning, and mentoring.

• Employee Resource Groups.

• Manager program for guidance on career growth.

• Access to healthcare data assets and modeling tools.

• Bonus under the standard bonus policy, often exceeding 25% of base salary based on billable hours and managed work.