Actuarial Consultant
Actuarial Consultant - Remote
Position Overview
This role is focused on driving actuarial support for value-based care initiatives, particularly within Commercial and Medicare Advantage markets. The successful candidate will lead analytical efforts that inform the design, evaluation, and financial sustainability of provider-aligned contracts that reward quality and efficiency. This includes developing financial projections, monitoring performance metrics, and identifying actionable trends to optimize outcomes under alternative payment models.
Key Responsibilities
- Apply advanced actuarial techniques to evaluate and enhance value-based reimbursement strategies, including risk-sharing arrangements and performance-based incentives.
- Ensure the accuracy, completeness, and relevance of data used in contract modeling, financial projections, and performance assessments.
- Independently develop and communicate recommendations that influence contract design and strategic decisions, considering both internal and external stakeholder impacts.
- Lead cross-functional projects related to value-based contracting, defining scope, timelines, and deliverables.
- Identify and implement process improvements to enhance efficiency and analytical rigor in contract evaluation workflows.
- Respond to internal requests for actuarial insights related to provider performance, cost trends, and contract outcomes; review peer work for consistency and soundness.
- Support core departmental functions and provide mentorship or technical guidance to less experienced team members.
- Stay current on actuarial best practices, healthcare payment reform trends, and organizational priorities to ensure alignment with broader strategic goals.
Qualifications
- Bachelor's degree in actuarial science, mathematics, statistics, or a related field.
- Minimum of five years of actuarial experience, with preference for experience in value-based care, provider contracting, or healthcare analytics.
- ASA designation
- Strong foundation in actuarial principles, healthcare economics, and data analysis.
- Ability to translate complex actuarial findings into clear, actionable insights for both technical and non-technical audiences.
- Skilled in managing multiple priorities and delivering high-quality work in a fast-paced, collaborative environment.
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