Senior Healthcare Actuarial Consultant

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

📋 Description

• Assess healthcare proposal pricing, cost models, rate-development methodologies, utilization, reimbursement, trends, risk adjustments, and supporting data.

• Examine solicitation requirements, evaluation criteria, data specifications, amendments, Government assumptions, and other acquisition documents.

• Analyze claims, encounters, eligibility, membership, provider data, utilization, reimbursement, and other healthcare information for quality, completeness, consistency, and reasonableness.

• Review, adjust, maintain, test, and independently verify healthcare analytical and pricing models, including formulas, assumptions, inputs, outputs, and model logic.

• Evaluate healthcare cost projections, identifying key drivers, anomalies, unsupported assumptions, methodological limitations, data deficiencies, and financial risks.

• Conduct calculations, reconciliations, sensitivity analyses, scenario testing, benchmarking, and additional analytical procedures.

• Compare proposal assumptions and results against historical experience, Government assumptions, independent estimates, market data, and other relevant benchmarks.

• Formulate clarification questions, written findings, and recommendations regarding data, modeling, methodology, pricing, and potential financial risks.

• Collaborate with the Senior Pricing Consultant and acquisition team to facilitate proposal evaluations, negotiations, source selection, and analysis of proposal revisions and FPRs.

• Maintain traceable workpapers and convey clear analytical findings to technical, financial, acquisition, and Government stakeholders while safeguarding sensitive information.

⛳️ Requirements

• Must currently be authorized to work in the United States on a full-time basis.

• Ability to secure a Public Trust Security Clearance.

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Healthcare Analytics, or a related field.

• Over 7 years of experience in healthcare actuarial analysis, managed-care analytics, healthcare economics, reimbursement, claims analytics, healthcare pricing, data analytics, or a related field.

• More than 3 years of recent hands-on experience in developing, maintaining, significantly modifying, testing, or independently validating healthcare cost, utilization, reimbursement, pricing, or rate-development models, including direct analysis of underlying healthcare data and assumptions.

🏝️ Benefits

• Major medical benefits.

• Dental coverage.

• Vision coverage.

• 401(k) contribution plan.

• Holiday and personal time off.

• Professional development training & certification benefits.

• Health & wellness subsidies.

• Paid time off for community service.

• Reasonable accommodations may be provided.

• Performance recognition and rewards.