Senior Actuary
We are seeking a strategic and experienced Senior Actuary to lead actuarial initiatives focused on Medicare Advantage and Value-Based Care (VBC) programs. This role involves advanced modeling, financial analysis, and client consulting to support innovative care delivery and payment models that improve outcomes and reduce costs.
Key Responsibilities
- Lead actuarial analysis and strategy development for Medicare Advantage bids, pricing, and risk adjustment.
- Design and evaluate VBC models, including shared savings, capitation, and bundled payment arrangements.
- Collaborate with clinical, finance, and analytics teams to assess program performance and identify improvement opportunities.
- Provide thought leadership and guidance to clients on regulatory changes, CMS methodologies, and market trends.
- Mentor junior actuaries and analysts, and review technical work for accuracy and insight.
- Present findings and recommendations to internal stakeholders and external clients.
Qualifications
- ASA or FSA designation required.
- 5+ years of actuarial experience, with significant exposure to Medicare Advantage and VBC.
- Deep understanding of CMS bid processes, risk adjustment, and healthcare cost/utilization metrics.
- Strong proficiency in actuarial modeling tools and data analysis (Excel, SQL, SAS, R, or Python).
- Excellent communication and client-facing skills.
- Proven ability to manage complex projects and lead cross-functional teams.
Preferred Skills
- Experience with provider contracting and performance analytics.
- Familiarity with population health strategies and clinical program evaluation.
- Consulting experience in a fast-paced, client-driven environment.
FAQs
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