Medicaid Actuarial Senior Consultant

Job Summary

Provide strategic and technical consulting services to public sector clients, focusing on Medicaid reimbursement. Support engagements in areas such as actuarial rate development, Medicaid policy, budget forecasting, fiscal analyses, and risk adjustment. Participate in business development efforts for Federal and State governments, employer groups, and other public entities. Engage in the transformation of the health care sector through innovative actuarial solutions.

Responsibilities

• Support 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
• Support business development efforts for Federal and State governments, employer groups, and other public entities
• 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
• Work independently and collaborate as part of a team
• Communicate effectively both verbally and in writing
• Show meticulous attention to detail and high-quality work product
• Build and sustain professional relationships
• Lead projects or workstreams
• Manage and prioritize multiple tasks in a fast-paced and dynamic environment
• Show strong interpersonal skills and maintain a professional demeanor
• Meet deadlines
• Mentor and provide clear guidance to others

Requirements

• 5+ years of health actuary experience and consulting and/or health plan/insurance company experience
• 2+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
• 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
• Experience with reimbursement models – including value based care/ACO modeling
• Knowledge of group insurance products including disability, long term care, etc.

Qualifications

• Bachelor’s Degree
• Exam progress towards ASA or FSA
• ASA with progression to FSA, FSA, or career ASA designation

Benefits

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Pay & Schedule

Details regarding pay and schedule will be provided upon successful completion of the hiring process.

Schedule

Details regarding schedule will be provided upon successful completion of the hiring process.

Company Information

At Deloitte, we believe in creating an inclusive culture where everyone feels valued and respected. Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. We offer a wide range of benefits to support our people's well-being and growth.