Medicaid Actuarial Senior Manager
- Provide strategic and technical consulting services to public sector clients
- Lead engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment
- Lead and manage end-to-end business development efforts for Federal and State governments, employer groups, and other public entities, including proposal development and capture
- Participate in the transformation of the health care sector through innovative actuarial solutions, such as AI-driven solutions, development of frameworks inclusive of social drivers of health, and transition of payment models to value-based payment frameworks
- Address complex, ill-defined problems with strong technical and innovative approaches
- Apply business-oriented strategies to enhance client outcomes and solutions
- Collaborate with cross-functional teams to deliver comprehensive actuarial services
- Engage in continuous learning and adaptation to emerging health care trends and technologies
- Bachelor's Degree required
- 15+ years of health actuary experience and consulting and/or health plan/insurance company experience
- 8+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
- 5+ years of experience managing and leading teams
- ASA with progression to FSA or FSA
- Ability to travel up to 25%, on average, based on the work you do and the clients and industries/sectors you serve
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future
- Prior business development experience, preferably for state/local government clients
- Experience providing Medicaid consulting services to Government agencies
- Experience with Medicaid waivers (i.e., 1115, 1915 b/c, 1332)
- Experience with risk adjustment mechanisms
- Experience with Provider reimbursement streams (i.e., DSH, UPL, etc.)
- Experience with health care reform and working knowledge of the individual medical and small group markets
- Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various enrollee types
- Familiarity with group insurance products including disability, long term care, etc.
- Experience with product design and/or product strategy
- Experience with reimbursement models - including value based care/ACO modeling
- Successful marketing ability in selling services to prospects and existing clients
- Experience understanding trends in the marketplace
- Ability to work in a team environment sharing ideas and working collaboratively
- Excellent interpersonal and written/verbal communication skills
- Ability to work independently and in a team environment
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