Senior Consulting Actuary

This senior actuarial role provides strategic consulting support to healthcare organizations, government agencies, and insurance stakeholders navigating complex healthcare financial decisions. You will lead high-impact actuarial engagements focused on Medicaid programs, managed care, regulatory requirements, and healthcare transformation initiatives. The position combines advanced actuarial expertise with client advisory, analytics, and leadership responsibilities.

You will collaborate with multidisciplinary teams to deliver data-driven insights, financial models, and actionable recommendations. This opportunity is ideal for an experienced actuary who enjoys solving complex challenges and influencing healthcare policy and program outcomes. The role offers the chance to mentor professionals, contribute to business growth, and shape innovative healthcare solutions. The position can be performed remotely or from an office location, with limited travel requirements.

Responsibilities

• Lead actuarial engagements for state Medicaid agencies, public health organizations, and other healthcare clients.
• Develop and certify actuarially sound Medicaid managed care capitation rates, including risk adjustment methodologies and supporting documentation.
• Design and oversee encounter data analytics, including validation, utilization trend analysis, and reconciliation of encounter and financial information.
• Conduct financial modeling and analysis for healthcare programs, including HCBS, LTSS, PACE, waiver programs, and value-based payment initiatives.
• Support federal and state regulatory activities through cost-effectiveness analyses, budget neutrality assessments, state plan amendments, and waiver submissions.
• Perform fiscal and policy impact analyses related to rate changes, payment methodologies, provider programs, and healthcare transformation initiatives.
• Present actuarial findings and recommendations to clients, stakeholders, and regulatory organizations in a clear and actionable manner.
• Collaborate with multidisciplinary teams including healthcare analysts, policy specialists, economists, and clinical experts.
• Mentor junior actuarial professionals and contribute to team development initiatives.
• Stay current with CMS guidance, healthcare regulations, actuarial standards, and emerging trends affecting public and commercial health programs.
• Support client relationship development and contribute to strategic growth opportunities.

Requirements

• Associate or Fellow of the Society of Actuaries (ASA or FSA) with active membership in the American Academy of Actuaries (AAA).
• Minimum of 15 years of healthcare actuarial experience, including significant experience supporting state Medicaid programs.
• At least 5 years of experience developing, certifying, or filing actuarially sound Medicaid managed care capitation rates preferred.
• Proven ability to lead actuarial teams and manage complex client engagements.
• Strong expertise in Medicaid and commercial healthcare data, including claims data, encounter data, All-Payer Claims Databases (APCDs), and Medicaid Management Information Systems (MMIS).
• Deep understanding of CMS review processes, federal healthcare regulations, and Actuarial Standards of Practice (ASOP) compliance.
• Experience developing risk adjustment methodologies, financial models, and healthcare program analyses.
• Strong client-facing skills with the ability to communicate complex actuarial concepts to executive audiences and regulatory stakeholders.
• Experience supporting rate hearings, negotiations, or providing expert actuarial testimony preferred.
• Excellent organizational, analytical, and problem-solving skills.
• Advanced proficiency with Microsoft Excel, Word, and PowerPoint.
• Ability to work collaboratively in a consulting environment while managing multiple priorities.
• Interest and experience in supporting business development initiatives preferred.

Benefits

• Competitive base salary range of $200,000 to $275,000, depending on experience, qualifications, and other relevant factors.
• Flexible work options, including remote work or office-based opportunities.
• Comprehensive benefits package designed to support physical, mental, financial, and professional well-being.
• Opportunities for career growth, advancement, and leadership development.
• Collaborative environment with experienced professionals across healthcare, actuarial, analytics, and consulting disciplines.
• Professional development opportunities and support for continued learning.
• Meaningful work supporting healthcare organizations, government programs, and communities.
• Reasonable accommodations provided throughout the hiring process and employment experience.