Medicaid Actuarial Manager

About the role

The Deloitte Human Capital team helps organizations create value through people performance. We work with clients to reimagine work, the workforce, and the workplace across the enterprise and to transform their HR functions with AI and emerging technology.

Responsibilities

• 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
• Transform 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

Requirements

• Bachelor's Degree required
• 10+ years of health actuary experience and consulting and/or health plan/insurance company experience
• 5+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
• 1+ years of experience managing and leading teams OR 1+ years of experience managing and leading teams and leading business development efforts, including selling services to prospective and existing clients
• ASA with progression to FSA or FSA
• 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
• 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
• Understanding trends in the marketplace

Qualifications

• Ability to work independently and collaborate as part of a team
• Effective written and verbal communication skills
• Meticulous attention to detail and quality of work product
• Ability to build and sustain professional relationships
• Ability to lead projects or workstreams
• Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
• Strong interpersonal skills and professional demeanor
• Ability to meet deadlines
• Ability to mentor and provide clear guidance to others