Senior Manager – Consulting Actuary

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

📋 Description

• Design and implement actuarial, financial, and quantitative analyses that focus on Medicaid policy, eligibility, enrollment, utilization, spending, provider reimbursement, managed care payments, incentives, program performance, and operational impacts.

• Evaluate the impacts of federal and state Medicaid policy modifications on beneficiaries, providers, managed care organizations, program administration, and state expenditures.

• Create scenarios, analytical strategies, actuarial models, forecasts, fiscal impact assessments, cost projections, and quantitative methods utilizing healthcare data.

• Document methodologies, assumptions, constraints, uncertainties, and the implications for policy and implementation.

• Examine Medicaid managed care capitation, provider reimbursement, value-based and alternative payment models, Total Cost of Care initiatives, supplemental payments, directed payments, and multi-payer reform strategies.

• Assist with Medicaid financing and federal authority activities, encompassing waivers, state plan amendments, directed payments, provider reimbursement, budget neutrality, cost-effectiveness, and federal claiming approaches.

• Develop, review, or support actuarily sound healthcare payment and financing methodologies, including capitation rates, risk adjustment, risk scoring, trend development, rate rebalancing, and financial settlements.

• Lead intricate client inquiries, analytical strategies, work plans, substantive actuarial and quantitative projects, and ensure analytical quality.

• Engage directly with senior Medicaid, government, and healthcare executives.

• Convert complex findings into reports, presentations, policy briefs, technical documentation, and actionable recommendations.

• Collaborate across various disciplines including actuarial, economic, policy, provider finance, data science, healthcare analytics, and operations.

• Mentor junior staff and assist in proposals, client opportunities, relationship building, business development, and the expansion of BerryDunn’s Medicaid, actuarial, and healthcare consulting services.

⛳️ Requirements

• Associate or Fellow of the Society of Actuaries with active membership in the American Academy of Actuaries.

• Annual affirmation of compliance with the U.S. Qualification Standards, including relevant Specific Qualification Standards.

• A minimum of 15 years of pertinent health actuarial experience.

• Significant experience supporting Medicaid programs, public-sector healthcare initiatives, managed care organizations, health insurance programs, healthcare financing analyses, or healthcare consulting clients.

• Experience in applying actuarial methods for healthcare cost projections, fiscal impact analyses, payment modeling, risk adjustment, managed care financing, provider reimbursement, program evaluation, or similar quantitative analyses.

• Comprehensive knowledge of Medicaid policy, healthcare financing, managed care, provider payment, reimbursement, actuarial standards of practice, CMS requirements, and federal and state healthcare regulations.

• Proficiency in analyzing healthcare claims, encounter, eligibility, enrollment, utilization, provider, financial, demographic, or related data.

• Capability to independently manage complex actuarial or quantitative projects, exercise professional and methodological judgment, supervise technical staff, and collaborate with multidisciplinary teams.

• Exceptional written, verbal, and presentation abilities.

• Strong client relationship management, project oversight, and leadership skills.

• Advanced proficiency in Microsoft Excel, Word, and PowerPoint.

• Capacity to handle sensitive Medicaid, provider, and beneficiary data, including personally identifiable information and protected health information, while adhering to privacy, security, confidentiality, and HIPAA regulations.

• Availability to work during Hawaii Standard Time hours.

• Willingness to travel occasionally within Hawaiʻi, the Pacific region, and the continental United States; expected travel is less than 25% per year.

🏝️ Benefits

• Benefits that promote physical, mental, career, social, and financial well-being.

• Reasonable accommodations provided for the application, interview, and essential job functions.

• Commitment to an equal employment opportunity workplace.

• Initiatives focused on learning, development, and overall well-being culture.