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Wakely Consulting Group · 1 day ago

Consulting Actuary II - ACA Risk Adjustment

United States

Full-time

Remote

Mid, Senior Level

4+ years exp

Wakely Consulting Group is seeking a Consulting Actuary II with expertise in ACA risk adjustment. This role involves leading client engagements, managing workflows, and mentoring junior analysts while contributing to strategic growth and business development.

Health CareHealth DiagnosticsPersonal Health

Growth Opportunities

Responsibilities

Lead and manage client communication, working with multiple experts including non-actuarial staff to piece together and explain complex concepts in a clear and concise manner to clients

Manage timeliness of project deliverables by creating, updating, and executing project timelines

Delegate and train junior staff on performing actuarial analysis as it relates to risk adjustment operations

Learn Wakely Tools and Products

Assist with business development opportunities, such as responding to Request-For-Proposals (RFPs)

Train analysts on risk adjustment modeling including but not limited to risk adjustment transfer calculations, and review analysts work product

Collaborate across internal teams, such as ACA pricing actuaries, to deliver integrated, forward-thinking solutions

Maintain Client Relationships

Foster opportunities to promote Wakely tools, services, and products

Implement a strategic plan consistent to client needs

Increase client interaction skills by partnering with client lead on key initiatives

Identify and implement changes to avoid potential compliance risk

Create and communicate a project plan to include scope, goals, timelines, and billed hours

Manage, adjust, and communicate plan internally/externally throughout project

Deliver high quality work (conceptual & technical) within budget and timeline constraints

Organize and set priorities for assigned work

Continue exam progression towards FSA

Seek a deeper knowledge of multiple healthcare concepts and become known for expertise in a particular area

Identify and facilitate learning opportunities for project team and/or individuals

Create core materials, reference items and training programs

Represent Wakely’s brand through involvement in seminars/events and periodicals, etc

Learn and execute on new business and/or product lines

Contribute to new marketing initiatives to generate sales leads

Support and identify value added services to current clients

Apply operational improvement initiatives

Incorporate policies and procedures related to cross office collaboration into projects

Recruit top talent and participate in the selection and orientation process

Participate in community and professional volunteer activities/opportunities

Qualification

ACA risk adjustmentClaims analysisAnalytics modelingSQL/SASMicrosoft ExcelMicrosoft AccessEffective communicationTeam playerTime managementContinuous learningLeadershipEmotional intelligenceStrategic thinking

Required

Minimum of an ASA certification and a bachelor's degree in actuarial science, mathematics, or statistics required

Minimum of 4 years of healthcare actuarial experience, including Medicare, commercial ACA, and/or Medicaid lines of business, required

Demonstrated experience with ACA risk adjustment operations and accrual setting

Strong technical expertise in claims analysis, risk adjustment, and analytics modeling

Strategic thinker who anticipates market and regulatory changes and translates them into actionable client strategies

Ability and interest to build trust with clients and grow personal network

Passion for mentoring and developing actuarial talent

Excellent communication skills and ability to work effectively across cross-functional teams

Working knowledge of database/statistical analysis language (SQL/SAS), Microsoft Excel and Access

Initiative - Ability to decide in an independent way what actions should be taken

Effective Communication - Demonstrates the ability to convey thoughts and express ideas effectively, both verbally and written

Team Player - Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect

Time Management - Makes reasonable estimates of resources needed to achieve goals or complete projects. Uses methods to plan and track work and commitments

Continuous Learning - Displays an ongoing commitment to increasing skills

Leadership - Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and opportunities to learn through formal and informal methods

Emotional Intelligence - Consistently exercises sound judgment

Strategic Thinking - Formulates objectives and priorities and implements plans consistent with the long-term interest of the organization and employees

Company

Wakely Consulting Group

Going Beyond the Numbers At Wakely Consulting Group, an HMA company, our mission is to provide the utmost in professional actuarial, health care reform consulting and value-added services to the health care industry at a very reasonable cost.

Founded in 1999

Clearwater, Florida, USA

51-200 employees