BerryDunn — Assurance, Tax and Consulting · 20 hours ago
Senior Consulting Actuary
United States
Full-time
Remote
Senior Level, Lead/Staff
$200K/yr - $275K/yr
15+ years expBerryDunn is seeking a highly experienced and motivated Senior Consulting Actuary to join their Health Analytics Practice Group. This role involves leading actuarial engagements to provide strategic support to state-administered health insurance programs and other public health clients, while also contributing to the development of actuarially sound capitation rates and risk adjustment methodologies.
Accounting
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
Qualification
Required
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
Ability to work in a collaborative environment
Preferred
Five or more years of experience developing and certifying/filing actuarially sound capitation rates with CMS is strongly preferred
Experience providing expert testimony or support in rate hearings and rate negotiations preferred
A desire to generate new business strongly preferred
Advanced skills in Microsoft Excel, Word, PowerPoint
Company
BerryDunn — Assurance, Tax and Consulting
BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Charles S.
Chief Operating Officer of Consulting Services
Renee Bishop
Chief Operating Officer, Assurance, Tax and Advisory Services
Recent News
2024-04-19
2023-11-21
2023-01-04
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