Senior Consulting Actuary

About the role

BerryDunn is seeking a highly experienced and motivated Senior Consulting Actuary to join our Health Analytics Practice Group. This individual will lead actuarial engagements providing strategic support to state-administered health insurance programs, state insurance regulators, and other state agencies nationwide. Other potential clients include non-profit managed care organizations, accountable care organizations, and large employer groups.

Responsibilities

• Lead actuarial engagements for state Medicaid agencies and other public health clients.
• Design and oversee encounter data analytics, validating completeness and accuracy, producing utilization trend analyses, and reconciling encounter to financial data for managed care oversight.
• Develop and certify Medicaid managed care capitation rates that are actuarially sound, including risk adjustment methodologies.
• Develop and apply risk scoring methodologies to support capitation rate rebalancing, including calculation of individual risk scores and risk-adjusted settlements.
• Conduct financial analyses and modeling for HCBS, LTSS, and PACE programs.
• Provide strategic guidance on program design, waiver development and submission support, and value-based payment models.
• Support federal authority activities, including cost-effectiveness and budget-neutrality analyses for 1915(b)/(c) and 1115 waivers, state plan amendments, directed payments, and provider tax programs.
• Conduct ad hoc fiscal and policy impact analyses, including rate modifications, hospital rebasing, UPL/GME payments, and pay-for-performance calculations.
• Collaborate with multidisciplinary teams including underwriters, policy experts, data analysts, health economists, and clinical consultants.
• Present complex actuarial findings to clients, stakeholders, and regulatory bodies in a clear and actionable manner.
• Mentor junior actuarial staff and contribute to professional development initiatives.
• Stay current with federal and state regulations, CMS guidance, and emerging trends in commercial and public health programs.

Requirements

• 15+ years of actuarial experience, attainment of Associate or Fellow of the Society of Actuaries, membership in the American Academy of Actuaries, and annual atsation to meeting the US Qualification Standards and Specific Qualification Standards.
• Five or more years of experience developing and certifying/filing actuarially sound capitation rates with CMS is strongly preferred.

Qualifications

• FSA or ASA with active membership in the AAA (required).
• 15+ years of health actuarial experience, including at least 5 years supporting or employed by a state Medicaid agency.
• Demonstrated ability to lead a team of actuaries.
• Proven experience developing actuarially sound managed care capitation rates, risk adjustment methodologies, and waiver cost-effectiveness models.
• Deep familiarity with CMS review processes, federal regulatory standards, and ASOP compliance.
• Expertise with Medicaid and commercial claims/encounter data, including All-Payer Claims Databases (APCDs) and Medicaid Management Information Systems (MMIS).
• Excellent communication skills and a strong record of producing defensible actuarial documentation for CMS, state agencies, and legislative oversight entities.
• An executive presence and strong client relation skills.
• Experience providing expert simony or support in rate hearings and rate negotiations preferred.
• Ability to work in a collaborative environment.
• A desire to generate new business strongly preferred.
• Advanced skills in Microsoft Excel, Word, PowerPoint.

Skills

• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.
• Proficiency in actuarial software and tools.
• Knowledge of healthcare regulations and policies.
• Ability to manage multiple projects simultaneously.
• Strong leadership and mentoring abilities.

Benefits

The base salary range targeted for this role is $200,000 - $275,000. This salary range represents BerryDunn’s good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case.

BerryDunn Benefits & Culture

Our people are what make BerryDunn special, and in return we strive to provide our employees with benefits that go beyond what’s expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn.

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.