Key Responsibilities:
Actuarial Analysis: Conduct comprehensive actuarial analyses of Medicare Advantage programs, including pricing, risk assessment, and financial forecasting.
Data Analysis: Collect, analyze, and interpret large datasets related to healthcare claims, utilization, and population demographics to identify trends and provide data-driven recommendations.
Modeling: Develop and maintain actuarial models to assess the financial impact of various healthcare strategies and scenarios, including risk adjustment and risk mitigation strategies.
Regulatory Compliance: Stay up-to-date with the latest regulations and guidelines related to Medicare Advantage programs and ensure that client strategies are compliant.
Client Consultation: Collaborate closely with clients to understand their unique needs and challenges, providing expert guidance and recommendations to support their Medicare Advantage initiatives.
Report Generation: Prepare and present clear and concise reports to clients, conveying complex actuarial findings in a manner that is understandable to non-actuarial stakeholders.
Team Collaboration: Work closely with cross-functional teams within [Health Consulting Firm], including healthcare analysts, consultants, and data scientists, to deliver holistic solutions to clients.
Continuous Learning: Stay informed about emerging trends, technologies, and best practices in Medicare Advantage and actuarial science to enhance the firm's capabilities.
Qualifications:
- ASA or FSA designation
- Proven experience as an actuary with a focus on Medicare Advantage programs.
- Strong proficiency in actuarial modeling and statistical analysis using software such as SAS, R, or Python.
- In-depth knowledge of Medicare Advantage regulations, risk adjustment methodologies, and CMS guidelines.
- Exceptional problem-solving and critical-thinking abilities.
- Strong project management skills and the ability to work effectively in a collaborative team environment.
